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Title Computer-Assisted Environmental Control for Newborns
Author(s) Paul H. Perlstein, Neil K. Edwards, Harry D. Atherton, Marcus C. Hermansen
Source The Use of Computers in Perinatal Medicine, Chapter 21, Pages 363-373
ISBN 0-03-061513-5
Publisher Praeger Publishers, New York, NY
Publication Date 1982
Abstract A computer was first introduced into the intensive care unit nursery (ICU nursery) at Cincinnati General Hospital in 1971. Initial use centered around implementation of an algorithm for controlling temperatures in standard convectively heated incubators. The goal was to maintain a thermally neutral microclimate in incubators so as to keep the body temperatures of infants within the normal range and reduce thermally induced metabolic work to a minimum. In addition, the algorithm was designed to prevent sudden temperature changes within the incubators and thus reduce apneic spells and bradycardia in susceptible infants. Furthermore, because infants tend to become adapted to thermoneutral conditions, the algorithm was modified to wean babies transitionally from a consistently warm incubator to the less-controlled temperature environment of the air-conditioned nursery. The use of the system was documented to correlate with an increase in infant survival for babies requiring neonatal intensive care for respiratory distress syndrome (RDS) and weighing greater than 799 grams at birth. Furthermore, it was shown that the group of infants in incubators with computer-assisted temperature control required significantly fewer calories per kilogram body weight per day during the first 6 days of life than did a matched control group of infants receiving care in standard incubators, and yet the 7-day weight loss (expressed in percent of birth weight) was slightly less in the study as compared with the control group. ... The development of the Cincinnati ICU nursery computer system is ongoing and, in addition to the control and alarm functions, now provides video display of patient monitoring and laboratory data. It also generates outputs relevant to medical records, patient billing, quality control, and so forth. These new systems are being evaluated using controlled trials to assess both the beneficial and adverse influences upon the care of sick neonates.


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