A laminar flow unit for the care of critically ill newborn infants
Notice bibliographique
Résumé
Jose MR Perez,1 Sergio G Golombek,2 Carlos Fajardo,3 Augusto Sola41Stella Maris Hospital, International Neurodevelopment Neonatal Center (CINN), Sao Paulo, Brazil; 2M Fareri Children’s Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY, USA; 3University of Calgary, Calgary, Canada; 4St Jude Hospital, Fullerton, California, CA, USAIntroduction: Medical and nursing care of newborns is predicated on the delicate control and balance of several vital parameters. Closed incubators and open radiant warmers are the most widely used devices for the care of neonates in intensive care; however, several well-known limitations of these devises have not been resolved. The use of laminar flow is widely used in many fields of medicine, and may have applications in neonatal care.Objective: To describe the neonatal laminar flow unit, a new equipment we designed for care of ill newborns.Methods: The idea, design, and development of this device was completed in Sao Paulo, Brazil. The unit is an open mobile bed designed with the objective of maintaining the advantages of the incubator and radiant warmer, while overcoming some of their inherent shortcomings; these shortcomings include noise, magnetic fields and acrylic barriers in incubators, and lack of isolation and water loss through skin in radiant warmers. The unit has a pump that aspirates environmental air which is warmed by electrical resistance and decontaminated with High Efficiency Particulate Air Filter (HEPA) filters (laminar flow). The flow is directed by an air flow directioner. The unit has an embedded humidifier to increase humidity in the infant’s microenvironment and a servo control mechanism for regulation of skin temperature.Results: The laminar flow unit is open and facilitates access of care providers and family, which is not the case in incubators. It provides warming by convection at an air velocity of 0.45 m/s, much faster than an incubator (0.1 m/s). The system provides isolation 1000 class (less than 1,000 particles higher than 0.3 micron per cubic feet at all times). This is much more protection than an incubator provides and more than radiant warmers, which have no isolation whatsoever. Additionally, it provides humidification of the newborn’s microenvironment (about 60% relative humidity), which is impossible with a radiant warmer, which produces high water body loss. It has no mechanical barriers like acrylic walls, its magnetic field is lower than an incubator (0.25 µt versus 1.2 µt), and the noise is minimal compared to incubators. The unit is also able to provide controlled total body hypothermia, which is not possible with either of the other two units.Conclusion: The laminar flow unit for neonatal care is a novel device which we recently developed. The introduction of laminar flow technology represents a real innovation in the neonatal field. We have described the various components of the unit and the potential advantages for management of ill neonates. This will hopefully lead to improved clinical outcomes and more effective neonatal management and safety.Keywords: laminar flow, newborn intensive care, incubator, radiant warmer
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Prédiction machine sur la base complète
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».