The Importance of Noise Attenuation Levels in Neonatal Incubators

Fernández-Zacarías, Francisco; Puyana‐Romero, Virginia; Molina, Ricardo Hernández

doi:10.3390/acoustics4040049

Cited by 3 publications

(1 citation statement)

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“…Both the lack of sound intervals and the intensity can cause tinnitus, hearing loss, periods of deafness and even permanent deafness. Recently Fernandez-Zacarias et al [21] recognized that it is necessary to reduce the nL insulation inside the incubator cabin and especially that which is produced by the motor fan.…”

Section: Discussionmentioning

confidence: 99%

Innovative instrumentation to strong reduction of the noise levels inside newborn incubators used in the neonatal intensive care units

Ramos

Zebende

Cruz

2023

Biomed. Phys. Eng. Express

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In spite of the advent of medical technology, modern newborn incubators (NIs) do not protect them from high noise levels in the neonatal intensive care units (NICUs). Allied to bibliographical research carried out measurements were made inside the dome of a NIs and the results show that the sound pressure levels, or noises, are much more intense than the levels stipulated by the norm NBR IEC 60.601.2.19 of ABNT. These measurements revealed that the NIs air convection system motor is the main source of excess noise. In view of the above, a project was developed with the objective of significantly reducing the noise level inside the dome by modifying the air convection system. Thus, a quantitative study was developed, based on the experimental method, where a ventilation mechanism was designed, constructed and tested, which operated from the network of medical compressed air, present in the NITUs and maternity rooms. Respectively, before and after the modification of the air convection system, the data of relative humidity, air velocity, atmospheric pressure, air temperature and noise [(64.9 % ur / 33.1 % ur); (0.27 m/s / 0.28 m/s); (1.013.98 hPa / 1.013, 60 hPa); (36.5 ºC / 36.3 ºC); (45.9 dBA / 30.2 dBA], were collected by electronic meters that registered the conditions of the external and internal environment of the dome of an NI with a passive humidification system. The noise measurements in the environment showed that there was a strong reduction of 15.7 dBA, or 34.2% of internal noise, measured after the modification of the ventilation system, showing a significative performance of the modified NI. Therefore, our results may be a good choose to improve NI acoustics to enable optimal care of the neonate in the neonatal intensive care units.

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Section: Discussionmentioning

confidence: 99%

Innovative instrumentation to strong reduction of the noise levels inside newborn incubators used in the neonatal intensive care units

Ramos

Zebende

Cruz

2023

Biomed. Phys. Eng. Express

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Diagnosis of Noise Inside Neonatal Incubators under Free-Field Conditions

et al. 2023

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The study aims to diagnose the sound pressure levels inside incubators in a controlled environment under free-field conditions. The tests were carried out in a semi-anechoic room under the standard UNE-EN ISO 3745:2012/A1:2018 in three different operating states: off, on, and on with a temperature alarm triggered. Sound pressure levels were analyzed in three different models of incubators, both inside and outside. The main noise indices analyzed were the corrected equivalent continuous level (LKeq) and the equivalent continuous level (Leq) in third-octave bands. The results obtained under normal operating conditions showed variations among the different incubators, with overall values between 48.8 and 56.3 dBA. The influence of the alarm considerably worsened these data. The values obtained showed that premature newborns are exposed to noise levels above international recommendations. All incubators tested showed the presence of tonal components, both outside and inside the incubator cabin, and, in some cases, low-frequency components, but no impulsivity components were observed in any case.

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A Care-bundle to Prevent Germinal Matrix–Intraventricular Hemorrhage in Neonates

The LAYA Group of the Global Newborn Society,

Ayad

2024

Newborn

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Germinal matrix-intraventricular hemorrhages (GM-IVHs) can be seen in up to 25-30% of premature infants. These are associated with a major psychological, social, and financial challenge for care-providers and families caring for premature infants all over the world. The severity is usually classified based on the location and volume vis-à-vis that of the cerebral ventricles, including (A) Grade I GM-IVHs localized in the germinal matrix; (B and C) Grade II and III hemorrhages occupying less than and more than 50% of the ventricular cavities, respectively; and (D) Grade IV IVHs that extend into the surrounding parenchyma with/without a periventricular hemorrhagic infarction (PVH). Germinal matrix-intraventricular hemorrhages have been associated with impaired neurodevelopment (17.5%), static physical disabilities in cerebral palsy (7-63%), deafness (8.6%), and blindness (2.2%). Considering the complex etiopathogenesis of GM-IVH and the fact that most of these events occur within a temporally-delimited period of the first 72 hours after birth, there is increasing interest in the structured application of 3-5 well-accepted preventive measures as a quality improvement (QI) "care bundle" during the high-risk period. In this article, we have described the evidence on which our GM-IVH bundle is based. We have carefully evaluated antenatal factors such as the history of having received steroids and magnesium sulfate, perinatal measures such as delayed cord clamping, management of thrombocytopenia and/or coagulopathy, and postnatal measures such as maintaining a midline head position, cautious endotracheal suctioning and blood withdrawals, and avoidance of routine flushing of intravenous and arterial lines. Based on the strongest evidence and practice consensus, we have adopted a 4-point bundle to prevent GM-IVH in premature infants: (A) Appropriate neonatal resuscitation with, if possible, delayed cord clamping; (B) Golden-hour care; (C) Gentle care of outborn infants including safe transport and avoiding hemodynamic instability; and (D) if needed, management of perinatal thrombocytopenia and coagulopathy. In the next 3-5 years, we will report compliance and changes in the incidence/severity of GM-IVH at our centers.

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The Importance of Noise Attenuation Levels in Neonatal Incubators

Cited by 3 publications

References 50 publications

Innovative instrumentation to strong reduction of the noise levels inside newborn incubators used in the neonatal intensive care units

Innovative instrumentation to strong reduction of the noise levels inside newborn incubators used in the neonatal intensive care units

Diagnosis of Noise Inside Neonatal Incubators under Free-Field Conditions

A Care-bundle to Prevent Germinal Matrix–Intraventricular Hemorrhage in Neonates

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