2 incubator medical equipment

2 incubator medical equipment

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Lecture-2: Infant Incubator
SherifH. El-Gohary, Phd
Assistant Professor,BiomedicalEngineering
[email protected]
Medical
Instrumentation
SBE 310

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Outlines
•What is Incubator ?
•Why we need the incubator?
•Parameters ?
•Types of Heat Transfer?
•Modes of Temperature control
•Types of Incubators.
•Calibration of Baby incubator.

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Infant Health
•Deaths from hypothermia is often
masked under other causes
P: 212.854.6196 F: 212.854.8725
351 Engineering Terrace
1210 Amsterdam Ave
New York, NY 10027
Incuvive.weebly.com|
Annual estimated proportions of death by
cause for neonates
Worldwide
•38% of all under-5-year-old
deaths occurred in the
neonatal period (2001) [1]
–99% occurred in the
developing countries
–¾of neonatal deaths
occurred during the 1
st
week
of life
–24-45% of neonatal deaths
occur during the 1
st
24 hrs.
1.World Health Organization. Estimates. In: State of the world's
newborns. Washington: Saving Newborn Lives, Save the
Children/USA; 2001: PN1–49.
2.Source: World Health Organization. The Global Burden of
Disease: 2004 update. WHO, Geneva, 2008

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Incubator
“Incubare” latin= to lie on
Amicroenvironment to place newborns who are at
high risk, for maintenance of temperature and
humidity.
Infant incubator is a Bio Medical Device which
provides Warmth, Humidity and Oxygen all in a
controlled environment as required by the New born

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Purposes
Maintenance of thermo neutral ambient
temperature.
Provision of desired humidity and
oxygenation.
Observation of very sick neonates.
Isolation of newborn babies from infection,
unfavorable external environment and
stimulations.

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Indication
Premature babies
Babies with low birth weight (<1500gm)
Hypothermic child (<320C)
Sick children
Also used in case of transportation of babies from one hospital to
another.
Also used to shift babies within the hospital for various investigations.
E.g, CT Scan and MRI.

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Functional Requirements and Constraints
http://
Constraints:
–Affordable
–Durable
–Easy to maintain and repair
–Portable
–Biocompatible and comfortable
–Intuitive and easy to use
–Useable in a variety of incubators and
cribs
–Low powered
–Easy to sterilize and clean
–Allow for high infant visibility
Functional Requirements:
–Maintain a temperature range
–Monitor infant temperature
–Ventilation
–Humidification
•40-80% relative humidity

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Parameters
•Temperature.
•Humidity.
•Air velocity.
•Sound.
•Oxygen.

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Anatomy of Skin
Skin is often considered the largest
organ system of the humanbody.
The average adult male has 18 square
feetof skin weighing over 6pounds.
Skin is comprised of three layers, the
Epidermis, Dermis and Subcutaneous
tissue.

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Skin -Function
Provides a physical barrier to theoutsideenvironment.
Assists in the development of theimmune system
Conserves body fluid bypreventing evaporativeloss.
Maintains bodytemperature.
Produces vitamin D in the presenceof sunlight.
Provides sensations of temperatureand touch.

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Normal range
Cold stress
Moderate hypothermia
Severe hypothermia Outlook grave, skilled
care urgently needed
Danger, warm baby
Cause for concern
37.5
o
36.5
o
36.0
o
32.0
o
Axillary temperature in the newborn (
0
C)

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Body Temperatures
Hypothermia
Low body temperature
Hyperthermia
High body temperature

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Hypothermia: Definition and Causes
•Those that survive often face [6]:
–Diabetes
–Heart disease
–Low IQ
–Other complications
•Normal temperature of newborn 36.5-37.5 °C
•Temperatures < 35 °C is “under temperature” 
hypothermic
–Indicates either surrounding is too cold or
infection
•Infant body acts as a heat sink [5]:
–Poor thermal insulation
–Large SA:V
–Small mass
–Heat loss via conduction, radiation, convection,
and evaporation
–Preterm infants are at highest risk of
hypothermia
5. Kawaji, Q. An alternative infant incubator: incubators for third
world countries.Johns Hopkins University.
https://jscholarship.library.jhu.edu.
6. Why embrace.Embrace. http://www.embraceglobal.org.

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Hypothermia
Remedy
Skin-to-skin contact with themother
Use a heated water-filledmattress
Use radiantheater
UseIncubator

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Hyperthermia
Hyperthermiacanbedefinedasacore
temperaturegreaterthan98.6°F(37.0°C)
InadultsitmayleadtoFever,Heat
syndromeslikecollapse,cramps,stroke
etc.

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Thermoregulation
Thermoregulationistheabilityofthebodyto
balancetheheatproducedinthebodywiththe
heatlostbythebody,therebymaintainingthebody
temperatureinthenormalrange.

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Thetemperatureofthebodyisregulatedby
hypothalamus
Sweatingbeginsalmostpreciselyataskin
temperature of37°C
Iftheskintemperaturedropsbelow37°C,a
varietyofresponsesareinitiatedtoconservethe
heatinthebodyandtoincreaseheatproduction
Thermoregulation

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Thermoregulation
HeatProduction
Due to metabolicactivities
HeatLoss
Evaporation
Conduction
Convection
Radiation

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19
Convection and Radiation
Convection
Occurs when air flow
carries heat to or
away from the body
Radiation
Radiant energy
exchange occurs
between two objects
that are not in direct
contact with
each other.

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Conduction and Evaporation
Conduction
Heat exchange that
occurs between
objects that are in
direct contact
with one
another
Evaporation
Occurs when liquid
is turned to vapor,
as with
amniotic
fluid on a
newly delivered
infant.

21. 21
Possible Sources
of Heat Loss

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Four ways a newborn may lose
heat to the environment
Thermal balance
Conduction
Radiation
Convection
Evaporation

23. 23Cold Items on Bed
Cold Walls
Cold Room Temp.
Radiation
Cold Blankets
Cold X-ray plates
Cold Scale
Conduction
Passing Traffic
Oxygen left on
Bed Near Air Vent
Convection
Tachypnea
Bath
Wet Diaper
Evaporation
Baby

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24
Strategies to prevent heat loss:
•CONVECTIVE HEAT LOSScan be prevented
by:
–Providing warm ambient air temperature
•Placing infants less than 1500 grams in incubators
•Keeping portholes of the incubator closed
•Warming all inspired oxygen
•On open warmers keeping sides up and covering infant if
possible
•Using Infant Servo Temperature Control

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25
Strategies to prevent heat loss:
•RADIANT HEAT LOSS can be prevented by:
–Avoiding placement of incubators, warming tables
and bassinets near cold windows, walls, air
conditioners, etc..
–Placing a knit hat on the infant’s head
–Wrapping tiny babies in saran or “bubble” wrap
–environmental temperature

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Strategies to prevent heat loss:
•CONDUCTIVE HEAT LOSScan be prevented
by:
–Placing a warm diaper or blanket between the neonate and
cold surfaces
–Placing infant on pre-warmed table at time of delivery
–Warming all objects that come in contact with the neonate
–Admitting infant to a pre-warmed
–Skin to skin contact

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Strategies to prevent heat loss:
•EVAPORATIVE HEAT LOSScan be prevented
by:
–Keeping the neonate and his/her environment dry.
–Drying the baby immediately after delivery.
–Placing preterm infant in occlusive wrap/bag at
delivery
–Delay bath until temperature is stable

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BIRTHWEIGHT AND TEMPERATURE RANGE
J.W and Ahmed, I. (1966) Range of critical
temperatures in sick and premature newborn babies
Archives of Diseases in Childhood 41: 417

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A-Baby incubator.
B-Transport baby incubator :
C-Radiant warmer

30. P: 555.123.4568 F: 555.123.4567
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Infant warming
devices
ClosedcareOpenCare
RadiantWarmer
Standalone
Wallmounted
Incubator
Transport
Incubator
NICU
Incubator
others
Warming
blankets, etc
Infant Warming Devices

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Embrace Warmer
•An infant warmer designed for
neonatal transport in the developing
world
•Uses a phase change material to
warm the child
Pros:
–Cheap
–Portable
Cons:
–Warming only
–No temperature monitoring
–Low infant visibility
–Need to refresh phase change material
every 4 hoursEmbrace. http://embraceglobal.org/

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VAN HEMEL Baby
Incubator
•Built specifically for the developing
world
•Uses light bulbs and the chimney
principleto heat and humidify
•Has an on/off switch for lights, a
thermometer, and a hydrometer
Pros:
–Cheap (~$500)
–Made with highly available materials
–High infant visibility
Cons:
–Not portable
–Bulky
–Does not have fine temperature
control
–Only monitors ambient temperature
–Must be shipped from Amsterdam
HEBI HemelBaby Incubator.
http://www.hebi-incubator.org/templates/heb/global/index.php?lngid=2&sqlmode=1&fid=144

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CaleoNeonatal
Incubator
•Providesa controlled warm, humid,
and oxygen-enriched environment
•Monitors and controls air
temperature, skin temperature,
humidity, oxygen concentration, and
weight
Pros:
–Intuitive and easy to use
–High infant visibility
–Monitors and alarms
–Rechargeable battery
Cons:
–Bulky and expensive
–Requires trained technician to repair
–Parts not widely available
P: 212.854.6196 F: 212.854.8725
351 Engineering Terrace
1210 Amsterdam Ave
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CaleoNeonatal Incubator, DragerMedical.
http://clinicalengineering.duhs.duke.edu/wysiwyg/downloads/caleo.pdf

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Incubator
•Closedcare
•Convectionprinciple
•HumidityAdjustment
•Lessdisturbances
•Oxygen controlavailable
Radiant warmer
•Opencare
•RadiationPrinciple
•NoHy.Adjust
•External Disturbancesmore
•No O2control
Differences

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Transport
Incubator
•Batterypowered
•Air (Manual) Modeonly
•Resuscitation apparatus
attached
•Compactable insize
NICU
Incubator
•Mainsoperated
•Both Air &Patient mode of
operation
•Notattached
•Bigger
Differences

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Parts of an incubator
Hood / canopy
Cabinet
Access panel
Mattress
Arm port holes
Bassinet
Latch release
Control panel
Oxygen inlet
Thermostat
Air inlet filter
Access port
Caster lock
Levers

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http://
Jones T, BelsingerH, MackinM, inventors; 1996 Jul.23.Heat controlled
humidifier for infant incubator. United States patent US 5,539,854.

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Block diagram

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Hardware Parts
Fan
The fan takes the filtered room air and blows it over or through the
heating element and the humidifier.
Without the fan the incubator would overheat.
Filter
•Simple incubators are equipped with washable foam filters. After
washing and drying they can be reused.
•Modern incubators however usually have disposable bacterial
filters. They can not be cleaned and have to be renewed.

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Heater
•A heating element made from coiled resistance wire as
known from hair dryers or the tube type (flat or coiled)
as seen in autoclaves are used to heat up the air. But
unlike in autoclaves, the heater has much less power and
thus does not get so hot.
•The power rating is between 100W and 300W.
•The heater is controlled by an electronic temperature
control unit via a relay or simply by a thermostat.
Hardware Parts

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Fan types-Blower ,Impeller
Heater types-ceramic, Quartztube
Hardware Parts

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Impeller –fan’s type

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Blower –fan’s type

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FRONT PANEL

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Air temperature
Patient temperature
Control temperature
FRONT PANEL

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Modes of Temperature control:
A.The Air Controlled mode.
B.The Skin Controlled mode.

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A. Controlled the Air :
•In air control mode, the air temperature is sensed and
used to provide the feed back to the system to turn on or
off according to the set value.
•Under the air control, the hot air flow is turned on
whenever the incubator air temperature goes below the
set temperature; maximum flow of hot air is allowed
from the heater into the incubator. This causes rapid rise
in the incubator air temperature.

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A. Controlled the Air (Cont)
•When the air temperature reaches the desired
value, the flow of hot air is turned off. With this
on-off control, there is an overshoot and
undershoot in the air temperature

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B. Skin control mode:
•In skin control mode, the skin temperature is sensed
and used to provide the feed back to the system to
turn on or off according to the set value.
•Under the skin control, the hot air flow is turned on
whenever the skin temperature goes below the set
temperature, and maximum flow of hot air takes
place into the incubator. This causes a rise in air
temperature.

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B. Skin control mode (cont)
•Skin temperature also goes up through
convection of heat from air to skin. When the
skin temperature reaches the desired value the
flow of hot air is turned off.
•Under this on-off control while skin
temperature is maintained constant there are
high fluctuations in air temperature

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Block diagram show On-Off
Control
Heater

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Noise
Prematurebabiesarefragile.Oneoftheirspecial
needsisquietenvironment.
However,intheneonatalintensivecareunit(NICU),
highnoiselevelsandfrequenthandlingleavethe
babiessleepdeprivedandmaydisrupttheirnormal
growthanddevelopment.

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Noise
Noiseeffectson the infantare,
•HearingImpairment
•Sleepdisturbance
•SomaticEffects
•Auditory Perception and EmotionalDevelopment

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Avoiding Noise
•No tapping or writing on top of the Incubator orhood.
•Careful and soft closure of the Incubator pot hole
doors.
•Neonatal Noise mufflers can beused.
•Medical staff should be advised to wear softshoe.
•To identify noisy areas and to isolatethem.
•Check existing machines for noiselevel
•Check all incoming new machines for theirnoise
•level before being put touse

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Noise Levels

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Controlled humidity in incubator:
•The humidity control system of the newborn incubator can
be presented under two aspects:
1. Passive humidity control system
This system consists of a reservoir with water.
This humidity of air occurs for the passive diffusion of the water for
the air that passes for the reservoir, not existing.
2. Active humidity control system
This system consists of a reservoir with water and the vapor is
controlled.

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Controlled humidity in incubator:
•I.Withoutwaterinreservoir:
Thattherelativehumidityoftheairinsidenewbornincubator,
withoutwaterinhumidityreservoir,gooutfromthebandof
comfortestablishedbyStandard(40%-60%).
•II.Withwaterinreservoirandwithout
controlofhumidity:
Therelativehumidityoftheairinsideofthenewbornincubator
thatusedwaterinhumidityreservoir,withoutcontrolof
humidity,gooutfromthebandofstandard.

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Controlled humidity in incubator:
•III. With water in reservoir and controlled
humidity:
The relative humidity of the air inside of the newborn incubator
that used water in humidity reservoir, with control of humidity,
if it kept inside of a band preset.

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Alarms
•Low Temp –check Alarm limits,sensor&
calibrateif required
•HighTemp-checkAlarmlimits,sensor&calibrate
if required
•Probe Fail –check probe for any damage &
calibrate if required

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Hardware Alarms
•Powerfail-checkmainspresent,powercord,fuse,
power supplyPCB
•Fan fail-check Fan, Fan voltage, Fan controlcircuit.
•HeaterFail-checkHeaterresistance,heatervoltage,
heater controlcircuit.
•Air probe-Patient probe, safety probe-respective
sensors, calibrate ifnecessary.

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Head hood
•Singlepiece,RoundShape,madeofautoclavable
Polycarbonatematerial.
•Trauma free Silicone neck adjustmentflap.
•Bilateral oxygen nozzle ( prevents direct flow of cold
oxygen on patient’shead.
•Height :7.5”.
•Width :8.5”.

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X-ray tray:
An X-ray tray may be fitted beneath the bassinet to
enable X-rays to be taken without disturbing the infant.
This may be done with the canopyup ordown.
•X-rays taken using the tray may result in a higher dose to
the patient because of the bedding, the mattress and
otherplastics.

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Schematic
of Baby
inside the
Incubator
with all
connections

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Idea #1
•Lines the perimeter of
incubator
•Makes use of a heater,
bubble humidifier, and a
fan to accommodate
functional requirements
PROS:
–Maybe used in a crib with dome covering
–Comfortable
–High infantvisibility
CONS:
–Shape may need to be adjusted for each incubator unit
–Safety concern of location of heater and humidification
system

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Idea #2
•Portable box that is inserted into incubator
•Makes use of a heater, bubble humidifier, and a fan to
accommodate function requirements
PROS:
–Comfortable
–High infant visibility
–Portable
CONS:
–Safety concern of location of heaterand humidification
system
–May reduce space available for infant

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NY 10001
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Idea #3
•Mat that can be inserted into
incubator
•Makes use of phase change
material and a fan.
PROS:
–Eliminates the need for a separate humidification system
–Portable
–Prevents infant skin burns
CONS:
–May limit infant visibility
–May require large quantities of power

73. P: 555.123.4568 F: 555.123.4567
123 West Main Street, New York,
NY 10001
www.rightcare.com|

74. P: 555.123.4568 F: 555.123.4567
123 West Main Street, New York,
NY 10001
www.rightcare.com|