Peters C, Bauer M, Speidel U, Jung E, Homberg F, Schofer O
KLN-Kinderklinik Kohlhof, Neunkirchen.
Klin Padiatr. 1997 Sep-Oct;209(5):315-20. doi: 10.1055/s-2008-1043970.
Despite increasing numbers of centers for perinatology, transportation of newborns and premature infants can not totally be avoided for several obvious reasons. The following investigations were carried out as part of our quality control measures of the established neonatal transportation system, and were aimed on the optimization of a new neonatal transportation equipment resulting in reduction of transportation stress caused by acceleration forces.
The new system investigated consisted of a Volkswagen type T4 equipped with a Dräger incubator type 5400, which was mounted on a pneumatic patient lift. We measured acceleration forces in three axes (expressed as K-Wert) as well as over a spectrum of frequencies (1-80 Hz). Measurements were taken at different points of the transportation unit during simulated transports driving a predetermined route. After obtaining informed consent of the parents, one actual transport of a newborn was used for an additional point measurement at the newborn's head.
The mean K-Wert was decreased by about 50% in the vertical axis between the chassis of the car and the incubator by activating the pneumatic patient lift. Without activating the lift the K-Wert increased by about 20% between the car's chassis and the incubator. The frequency analysis showed resonance effects between the different components of the system. However, by activating the patient lift, effective accelerations in the incubator were decreased to less than 0.1 m/s2 across the whole frequency spectrum evaluated. The single measurement at a newborn's head revealed similar acceleration forces at the head of the baby and under its head.
Utilization of a pneumatic patient lift can reduce acceleration forces. However, our results show that each system (car, incubator, and its base) has to be investigated and optimized for this purpose as a unit. Optimization of the complete system is necessary not only before its primary use but also in regular intervals over the years. Sometimes, further improvements can be reached with minor modifications such as the exchange of worn out rubber buffers.
尽管围产医学中心的数量不断增加,但由于一些明显的原因,新生儿和早产儿的转运仍无法完全避免。以下调查是我们既定新生儿转运系统质量控制措施的一部分,旨在优化一种新的新生儿转运设备,以减轻加速力引起的转运应激。
所研究的新系统由一辆配备Draeger 5400型暖箱的大众T4型汽车组成,该暖箱安装在气动病人升降机上。我们测量了三个轴向上的加速力(以K值表示)以及一系列频率(1 - 80赫兹)下的加速力。在模拟沿预定路线行驶的转运过程中,在转运单元的不同点进行测量。在获得家长的知情同意后,对一名新生儿的一次实际转运在新生儿头部进行了额外的点测量。
通过启动气动病人升降机,汽车底盘与暖箱之间垂直轴上的平均K值降低了约50%。未启动升降机时,汽车底盘与暖箱之间的K值增加了约20%。频率分析显示系统不同组件之间存在共振效应。然而,通过启动病人升降机,在整个评估的频率范围内,暖箱内的有效加速度降低到小于0.1米/秒²。在新生儿头部的单次测量显示,婴儿头部及其头部下方的加速力相似。
使用气动病人升降机可以降低加速力。然而,我们的结果表明,每个系统(汽车、暖箱及其底座)都必须作为一个整体进行研究和优化。不仅在首次使用前,而且在多年内定期对整个系统进行优化是必要的。有时,通过诸如更换磨损的橡胶缓冲器等小改动可以实现进一步的改进。