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BACKGROUND: Incubators and radiant warmers are essential equipment in neonatal care, but the typical 1,500 to 35,000 USD cost per device makes it unaffordable for many units in low and middle-income countries. We aimed to determine whether stable preterm infants could maintain thermoregulation for 48 h in a low-cost incubator (LCI). METHODS: The LCI was constructed using a servo-heater costing 200 USD and cardboard infant-chamber. We conducted this open-labeled non-inferiority randomized controlled trial in a tertiary level teaching hospital in India from May 2017 to March 2018. Preterm infants on full feeds and receiving incubator or radiant warmer care were enrolled at 32 to 36 weeks post-menstrual age. We enrolled 96 infants in two strata (Strata-1< 33 weeks, Strata-2 ≥ 33 weeks at birth). Infants were randomized to LCI or standard single-wall incubator (SSI) after negative incubator cultures and monitored for 48 h in air-mode along with kangaroo mother care. The incubator temperature was adjusted manually to maintain skin and axillary temperatures between 36.5 °C and 37.5 °C. During post-infant period after 48 h, SSI and LCI worked for 5 days and incubator temperatures were measured. The primary outcome was maintenance of skin and axillary temperatures with a non-inferiority margin of 0.2 °C. Failed thermoregulation was defined as abnormal axillary temperature (< 36.5 °C or >37.5 °C) for > 30 continuous-minutes. Secondary outcomes were incidence of hypothermia and required incubator temperature. Trial registration details: Clinical Trial Registry - India (CTRI/2015/10/006316). FINDINGS: Prior to enrollment 79(82%) infants were in radiant warmer and 17(18%) infants were in incubator care. Median weight at enrollment in Strata-1 and Strata-2 for SSI vs. LCI was 1355(IQR 1250-1468) vs. 1415(IQR 1280-1582) and 1993(IQR 1595-2160) vs. 1995(IQR 1632-2237) grams. Mean skin temperature in Strata-1 and Strata-2 for SSI vs. LCI was 36.8 °C ± 0.2 vs. 36.7 °C ± 0.18 and 36.8 °C ± 0.22 vs. 36.7 °C ± 0.19. Mean axillary temperature in Strata-1 and Strata-2 for SSI vs. LCI was 36.9 °C ± 0.19 vs. 36.8 °C ± 0.16 and 36.8 °C ± 0.2 vs. 36.8 °C ± 0.19. Mixed-effect model done for repeated measures of skin and axillary temperatures showed the estimates were within the non-inferiority limit; -0.07 °C (95% CI -0.11 to -0.04) and -0.06 °C (95% CI -0.095 to -0.02), respectively. Failed thermoregulation did not occur in any infants. Mild hypothermia occurred in 11 of 48(23%) of SSI and 16 of 48(33%) of LCI, OR 1.28 (95%CI 0.85 to 1.91). Incubator temperature in LCI was higher by 0.7 °C (95%CI 0.52 to 0.91). In the post-infant period SSI and LCI had excellent reliability to maintain set-temperature with intra-class correlation coefficient of 0.93 (95%CI 0.92 to 0.94) and 0.96 (95%CI 0.96 to 0.97), respectively. INTERPRETATION: Maintenance of skin and axillary temperature of stable preterm infants in LCI along with kangaroo mother care was non-inferior to SSI, but at a higher incubator temperature by 0.7 °C. No adverse events occurred and LCI had excellent reliability to maintained set-temperature. FUNDING: Food and Drug Administration (Award number P50FD004895).
ABSTRACT
Internet of Things (IoT), cloud computing and wireless medical sensor networks have significantly improved remote healthcare monitoring. In a healthcare monitoring system, many resource-limited sensors are deployed to sense, process and communicate the information. However, continuous and accurate operations of these devices are very important, especially in the infant incubator monitoring system. Because important decisions are made on the received information. Therefore, it is necessary to ensure the authenticity between the incubator monitoring system and doctors. In this work, a public key encryption based computationally efficient mutual authentication protocol is proposed for secure data transmission between incubator monitoring systems and doctors or administrators. The proposed protocol improves performance and reduces the computational cost without compromising the security. The security analysis part shows the strength of the proposed protocol against various attacks, performance analysis part shows that the proposed protocol performs better than other existing protocol based on Rivest-Shamir-Adleman and elliptic-curve cryptography schemes.
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Objective To analyze retrospectively the quality control data to enhance the infant incubator risk management. Methods The factors influencing the qualified rate of the infant incubator were analyzed by fishbone analysis method,and then the data statistics method was used to analyze the quality control data from 2013 to 2015 to find out the causes of the factors that affected the qualified rate. Some practical improvement measures were put forward. Results The improvement measures enhanced the qualified rate of the infant incubator quality control greatly. Conclusion The retrospective quality control data analysis contributes to bettering the infant incubator quality control and its clinical safety.
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Non-electric infant incubators are needed in remote areas that have no access to electricity to reduce infant mortality nationwide. In previous studies, non-electric infant incubators have been developed using phase change material of beeswax as the heating element. This study aims to improve the performance of beeswax non-electric infant incubator to obtain a more reliable and practical one. The design of the original beeswax cartridge in the form of copper boxes was modified into tubes of stainless steel. The geometry and location of the air holes were also modified. Wood that was previously used as the body material was replaced with polyurethane to reduce the weight of the incubator. The beeswax cartridges were heated using boiling water until the beeswax melted. For temperature measurement, five 0.5 mm k-type thermocouples were placed inside of the incubator according to the National Industrial Standard of SNI 16-4221. The beeswax cartridge arrangement was varied to obtain the best performance. The results showed that polyurethane provides infant incubator lighter and more practical to use. The new design of non-electric infant incubator was capable of providing a temperature of 32-36 °C for 2 h.
Subject(s)
Incubators, Infant , Polyurethanes/chemistry , Waxes/chemistry , Humans , Infant, NewbornABSTRACT
IOT(Internet of things) is a relatively new technology, more and more integrated into our lives. In this paper we use infant incubator for example, introduce the application of IOT technology to reduce the risk of the use of medical devices, and through the dynamic management to improve the management level and efficiency. Put forward a method of medical equipment linked. Combined with the point of IOT technology and sensor technology, we find out the actual needs of the management and use of infant incubator. For the dynamic management of medical equipment, we use sensors to control risk points. The system meets the needs of the hospital and patients in many areas.
Subject(s)
Incubators, Infant , Monitoring, Physiologic/instrumentation , Wireless Technology , Humans , Infant , Infant, Newborn , InternetABSTRACT
Objective:To implement quality control in whole life cycle for infant incubator, and ensure it working in safe and efficient situation.Methods:The parameter detection cases of infant incubator was analyzed and researched according to relative standards and requirements of technique for medical equipment.Results:The detection data and frequent failures of clinical cases revealed that there were parameter deviation existing in infant incubators. These deviations should be adjusted in time according to relative standards and requirements of technique for medical equipment.Conclusion:The quality control of whole life cycle for infant incubator is the necessary condition for ensuring medical quality and safety of patients. To pay attention to the quality control before and after application and after maintenance of the infant medical incubator, in order to ensure the medical equipment can achieve to meet the performance requirement of treatment and provide safe and efficient quality service for patients.
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Objective:To design Disinfection device of Infant incubator to address the existing infant incubator terminally sterilized in the presence of ultraviolet light disinfectant wipe and disinfection effect is not complete. Methods:Using vaporized hydrogen peroxide to kill spores of principle, to design a PLC and touch screen technologies such as infant incubator terminal disinfection device, mainly by vaporized hydrogen peroxide generator to accommodate infant incubator stainless steel tanks, gas communication piping, etc., through clean and dry after the infant incubator, pushed into stainless steel tanks, a key parameter set to start after the end of the introduction of the incubator to disinfection, disinfection by chemical and biological indicator discoloration indicator kill situation to judge. Results:The disinfection device for gas distribution, no disinfection dead, low-temperature sterilization effect is good and easy to verify, infant incubator for material compatibility, safe, reliable, easy to operate, chemical indicator from green to yellow, biological indicator Bacillus stearothermophilus cultured for 7 days, sterile growth. Conclusion:The device is easy to verify the sterilization effect, material compatibility, safety and reliability, reduce labor intensity in clinical neonatology and critical sections infant incubator terminal disinfection areas have higher promotion and application value.
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Objective: To imrove the current situation that disinfection is inconvenient and ineffective when infant incubators are used. Methods: To make some improvements without changing the structure and performance of existing infant incubators. Results: Built-in disinfection device is designed to overcome the difficult operation, poor effect and inconvenience in use. Conclusion:It has been awarded“the state utility model”for its safety and convenience (patent no:ZL200520117573.9).
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OBJECTIVE To analyze the hospital infection-related factors of infant incubator and their countermeasures.METHODS The hospital infections cases with the use of infant incubators from Jan 2005 to Sept 2008 were retrospectively analyzed.RESULTS From the 205 cases of children with the use of infant incubator,14 cases were infected,the hospital infection rate was 6.82%.Their risk factors were weak immunity,poor hygiene concepts,not strictly executing the hand disinfection systems and hygiene norms,unsatisfactory basic care and high humidity in incubators.CONCLUSIONS To strictly execute the disinfection system and hand hygiene norms,rationally use the antibiotics and to strengthen the basic care and care management can reduce the incidence of hospital infections.
ABSTRACT
Infant Incubator is the most important equipment in a infant ICU. This maintain adequate temperature and humidity for survival of infants. The final object of this research is Web-based monitoring of several infant incubators in ICU. To realize these objects, we developed a temperature/humidity sensing module which is interfaced to Web server board via RS485 port. We used a small micro controller in each sensing module. So the size of this module is small enough to be attached to incubator. We can access each sensing module with RS485 port on Web server board via network. As a first trial, we networked 4 infant incubators. The operator can send alarms to each incubator and these alarms are indicated with sounds and lights on measurement module. Our system can increase the convenience by a intensive central monitoring, so instant handling to some kinds of accident is possible.