Servo-controlled thermoregulation in extreme preterm and Extremely low birth weight infants during neonatal transport

Sharma, Neha; Fierens, Igor; Mohinuddin, S; Ratnavel, Nandiran; Kempley, Stephen; Sakhuja, Pankaj

doi:10.1136/archdischild-2019-318329

Cited by 3 publications

(6 citation statements)

References 5 publications

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“…18 An exothermic mattress or servo-controlled device with a mattress may be useful. 10,[19][20] In 2020, Bhatt et al reported that they achieved a low rate (<10%) of hypothermia after implementing the thermoregulation bundle, including an exothermal mattress, in their ELBW cohort. 20 These devices may increase the risk of hyperthermia 10,14,20 and their safety must be evaluated, especially for EPNs who have jelly-like immature skin.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, due to concerns about the mother's hyperthermia and medical staff fatigue at the higher room temperature, there are currently plans to change the target room temperature to 26 °C following recent recommendations 18 . An exothermic mattress or servo‐controlled device with a mattress may be useful 10,19–20 . In 2020, Bhatt et al .…”

Section: Discussionmentioning

confidence: 99%

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Decreased moderate admission hypothermia in extremely preterm newborns

Harada

Iwatani

Itani

et al. 2022

Pediatrics International

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Background Admission temperature is inversely correlated with mortality and morbidity risk in extremely preterm newborns (EPNs). As almost all EPNs require advanced resuscitation at birth, we improved a simple and comprehensive management protocol to reduce admission hypothermia. This study reports the changes over the past 15 years in the rate of admission hypothermia in all EPNs. It clarified the distribution of admission temperature and the risk factors for developing admission hypothermia in recent EPNs. Methods This single‐center study retrospectively analyzed the EPNs delivered at our institution between January 2006 and December 2020. The comprehensive management protocol, including warming equipment, plastic wrapping, aluminum‐polyethylene sheet, and room temperature, was applied to avoid heat loss during resuscitation. On admission, the rectal temperature was measured and defined as moderate (32.0–35.9 °C) or mild (36.0–36.4 °C) hypothermia. Results Overall (n = 432), the rate of admission with moderate hypothermia decreased from 48% in 2006 to 8% in 2020. In the recent evaluation of 80 EPNs delivered in 2017–2020, 10 (13%) and 26 (33%) had moderate and mild hypothermia on admission, respectively. Extremely preterm newborns with moderate‐to‐mild hypothermia had a significantly smaller gestational age and lower birthweight than those without hypothermia. No significant differences in the other perinatal and environmental risk factors were observed between EPNs with and without hypothermia. Conclusions Our comprehensive management protocol reduced the rate of moderate hypothermia on admission in EPNs to only 13%. However, eliminating mild hypothermia remains a challenge and requires continuous improvement, especially in smaller EPNs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Decreased moderate admission hypothermia in extremely preterm newborns

Harada

Iwatani

Itani

et al. 2022

Pediatrics International

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“…Currently, there are no warmers, incubators, and/or hybrid incubators such as the Giraffe OmniBed available in the United States that can display 2 temperatures and their difference while using the bed in servo-control. Servo control mode is most effective in maintaining normothermic temperatures in very preterm infants 17. Servo-control results in more time spent in the thermal neutral environment and more stable temperatures compared with air temperature control 18.…”

Section: Discussionmentioning

confidence: 99%

“…Servo control mode is most effective in maintaining normothermic temperatures in very preterm infants. 17 Servo-control results in more time spent in the thermal neutral environment and more stable temperatures compared with air temperature control. 18 Measuring 2 body temperatures and displaying the central-peripheral temperature difference may be important to give the clinician an overall picture of an infant's thermal gradients and stability.…”

Section: Implications For Practicementioning

confidence: 99%

Examining Use of Dual Point Temperature Display in Servo-Control With Early Preterm Infants

Dail¹,

Tavakoli²,

Moseley³

et al. 2021

Advances in Neonatal Care

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Background: Previously, we recorded periods of time with foot higher than abdominal temperatures in association with infection in preterm infants. Monitoring dual temperatures may be an important tool to assess infant instability. Currently, incubators cannot measure and display dual temperatures in servo-control mode. Purpose: To examine the usability of GE Healthcare's Giraffe OmniBed with research software to measure, display, and record dual temperatures, and their differences while in servo-control. In addition, nurses' perceptions of the use and display of dual temperatures and differences were evaluated. Methods: A multiple-case, mixed-methods design. Abdominal and foot temperatures were measured, displayed, and stored for 28 days for 14 preterm infants. Nurses were surveyed for satisfaction and preferences with the dual temperature display. Nurses noted abnormal temperature differences and infant condition in bedside journals. Results: Study infants were 26 to 31 weeks of gestational age and 670 to 1410 g. Abdominal, foot, and the abdominalfoot temperature difference was measured, recorded, and downloaded successfully in all infants over all days. Nurses liked using dual temperature display with the abdominal-foot temperature difference. Surveys indicated preferences for larger displays and alarms for abnormal values. Thermal instability, stimulation, and thermistor detachment were associated with abnormal thermal gradients. Two exemplar cases are presented. Implications for Practice: Monitoring dual temperatures adds information to the clinical assessment. Implications for Research: Studies are needed to examine relationships between abnormal thermal gradients and infections, infant stability, and nursing care along with the underlying physiologic mechanisms. Studies are needed for wireless dual temperature monitoring.

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“…Thermoregulation should be a significant problem in infant incubator. The target of body temperature for infants on average is around 37 C [1]. In general, this is for newborn babies, especially premature babies who have weak internal thermal regulation control to maintain their body temperature.…”

Section: Introductionmentioning

confidence: 99%

Cry Recognition for Infant Incubator Monitoring System Based on Internet of Things using Machine Learning

Sutanto¹,

Fahmi²,

Shalannanda³

et al. 2021

IJIES

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With the current technology trend of IoT and Smart Device, there is a possibility for the improvement of our infant incubator in responding to the real baby’s condition. This work is trying to see that possibility. First is by analyzing of open baby voice database. From there, a procedure to find out baby cry classification will be explained. The approach was starting with an analysis of sound’s power from that WAV files before going further into the 2D pattern, which will have features for the machine learning. From this work, around 85% accuracy could be achieved. Then together with sensors, it would be useful for infant incubator’s innovation by utilizing this proposed configuration.

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Servo-controlled thermoregulation in extreme preterm and Extremely low birth weight infants during neonatal transport

Cited by 3 publications

References 5 publications

Decreased moderate admission hypothermia in extremely preterm newborns

Decreased moderate admission hypothermia in extremely preterm newborns

Examining Use of Dual Point Temperature Display in Servo-Control With Early Preterm Infants

Cry Recognition for Infant Incubator Monitoring System Based on Internet of Things using Machine Learning

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