Prototype Hybrid Systems for Neonatal Warming: In Vitro Comparisons to Standard of Care Devices

Abstract

Preterm infants lack necessary thermoregulation. An ideal incubator should maintain a uniform and constant thermal environment. We compared the effectiveness of a supplemental heating blanket to improve the heating characteristics of two different incubator warming devices using assessment of their respective function alone as controls. Device A and device B, with and without a heating blanket (Harvard Apparatus), were instrumented with a distribution matrix of multiple temperature (n = 11) and humidity probes. These data were serially measured during warm up to 37.5 °C and through a series of open-door perturbations. The time constant, temperature variation, and change in air temperature were calculated. Data were analyzed for significance by 2-factor ANOVA for each respective incubator either turned on or off with either the heating blanket turned on or off. Device A warms faster (33.87% ; p < 0.05) than device B, but has a greater (37.27% ; p < 0.05) temperature variation during warmup. The heating blanket enhances the thermal response of device A during warmup, but does not alter those of device B. With the side door open, device A shows a smaller (−16.5% ; p < 0.05) temperature variation than device B; the heating blanket attenuates the temperature change in both devices. These results demonstrate that the use of a supplemental heating blanket, as well as device-related differences, may impact clinical control of a thermal environment.

Thermal responses of the newborn pig: In vivo comparison of two prototype hybrid systems to standard care neonatal warming

“…Controls) There were no in-cubator alone-related differences in the newborn pigs' thermal responses during warmup. This is in contrast to a previous in vitro study [5], which showed that the Caleo warms the incubator environment faster than the Giraffe . However, similar to the in vitro work, the Caleo maintained animal temperature more efficiently than the Giraffe , when the side access door was opened, and environmental humidity, when either the side access door or handports were opened.…”

“…We have demonstrated the advantages of a hybrid incubator and heating mattress combination in an in vitro setting [5] and here show again its benefits with a newborn model.…”

“…Modern neonatal incubators offer the patient a microprocessor controlled heated and humidified environment and more advanced options such as heliox [2]. Despite advances in design, disruptions in the integrity of the internal environment of the incubator could threaten the fragile infant [3][4][5].…”

Sensitivity of the Heat and Mass Transport System Within Neonate Clothing

“…. of two incubator warming devices was discussed by Hubert et al [2]. Optimizing the thermal environment can improve the survival chances of newborn babies.…”