INFANT RADIANT WARMERS

A radiant warmer is used to keep infant's core temperature stable at 37C°.

NEED FOR WARMING

The core temperature of the human body needs to be kept at a constant temperature of 37 degrees Celsius. Premature infants need to use as little energy as possible in keeping warm or cool, using it for growth instead. If the temperature goes too high or too low, then the organs can be damaged and illness or death can result.



The radiant warmer is used in a number of different situations: to warm a baby directly after birth, to regulate a baby’s temperature during long term care in hospital, to keep the patient warm during or after surgery, to keep a patient warm when they are minimally covered (because they are having a procedure or need to be accessible)



WORKING OF RADIANT WARMER

The patient lies on a bed with the skin exposed. The radiant warmer element is positioned above the patient. The warmer element emits heat radiation, which is absorbed by the patient’s skin and warms the patient. The air around the patient does not need to be warm because the radiant energy is absorbed directly by the skin.





RANGE OF VALUES

34 – 37C° skin temperature
36 – 37C° for core temperature

CONTROL PANEL OF A RADIANT WARMER



For more articles, see FISHER & PAYKEL HEALTHCARE

INFANT PHOTOTHERAPY

The phototherapy light shines light onto the baby’s skin. The light must be the correct wavelength (colour) and the correct intensity (brightness). It is used for treating a condition called Jaundice or Hyperbilirubinemia.




Jaundice or Hyperbilirubinemia



When red blood cells die and are broken down, a chemical called “bilirubin” is produced. Normally the bilirubin is processed by the liver and excreted from the body by the kidneys in the urine. The baby’s liver sometimes cannot process the bilirubin quickly enough and it begins to build up in the blood. Bilirubin is deposited in the skin, whites of the eyes, and mucous membranes (for example the inside of the mouth). When this occurs, the baby appears yellow and is said to be “Jaundiced”. Usually Jaundice disappears in 1-2 weeks and does not require special treatment. Some bilirubin in the blood is normal but when the concentration rises too high it is dangerous hyperbilirubinemia. An excessive level of bilirubin can lead to serious neurological damage such as brain damage and hearing loss.




WORKING OF PHOTOTHERAPY



During phototherapy the baby’s skin is exposed to blue light (420 – 500nm). The bilirubin deposited in the skin is “photoisomerised” (changed shape by the light) and becomes water soluble. This is a similar change that occurs normally in the liver. The photoisomerised bilirubin then dissolves back into the blood where it is excreted from the body in urine. The untreated bilirubin in the blood then deposits in the skin and the process continues until all or most of the bilirubin is removed. This happens over a long period of time, usually several days.



The effectiveness of the phototherapy depends on:
- the intensity of the therapeutic light
- the wavelength (colour) of the light
- the surface area of skin exposed


(BLUE LIGHT PHOTOTHERAPY)


(PROTECTION OF BABY EYES IN PHOTOTHERAPY TREATMENT)

Some phototherapy lights use white light instead of pure blue. White light contains all the colours but it is only the blue wavelengths that treat the Jaundice.


(WHITE LIGHT PHOTOTHERAPY)

UNIT : mW/cm2

RANGE OF VALUES

Wavelength = 420-500 nm (with the most important wavelength of 470 nm)
Intensity = 8 uW/cm2/nm to 25 uW/cm2/nm
(or) 0.65 mW/cm2 to 2 mW/cm2 (with a blue filter of 80nm bandwidth)

INFANT INCUBATORS

(INFANT INCUBATOR)

An infant incubator is used mainly to keep a baby’s core temperature stable at 37 degrees Celsius. Most incubators also humidify the air and can add extra oxygen.


(INFANT INCUBATOR WITH BABY)

NEED OF INFANT INCUBATORS

The core temperature of the human body needs to be kept at a constant temperature of 37 degrees Celsius. If the temperature goes too high or too low, then the organs can be damaged and illness or death can result. Premature babies (babies born before they are due to be born) have undeveloped nervous systems and also lack the energy to regulate their own temperature, so their temperature needs to be maintained by an incubator. We can only give small babies a small amount of food for growing. We want them to use all of their energy for growth rather than wasting it on keeping warm, so sometimes we use the incubator to help them grow faster.






WORKING OF INFANT INCUBATOR



The mattress where the baby lies is completely enclosed by a clear plastic canopy. The temperature in the incubator is increased by a heater element below the mattress. A motor driven fan near the heater draws in fresh air through a filter and blows it past the heater, warming the air. The air is directed up through slots into the area above the mattress and circulated around. The air temperature is monitored by temperature sensors and is adjusted by controlling the current to the heater. The incubator can also monitor the baby’s skin temperature by using a skin temperature probe, which is stuck onto the skin. The user can either set the incubator to control the temperature of the air or to control the temperature of the baby’s skin (servo control mode). Supplementary oxygen can be taken in by an oxygen inlet connection where it is mixed with the fresh air through the filter. The humidity can be increased by the use of water baths (passive humidification) or by dripping water on a heated element (active humidification). The baby is cared for through special access doors called arm ports.



UNITS

Temperature: degrees Celsius
Total gas intake: L/min
Relative Humidity %
Oxygen concentration: %

RANGE OF VALUES

Air Temperature: 32 to 38 C°
Baby skin temperature: 34 to 36 C°
Total gas intake: 35 L/min
Relative humidity: 50-100%