Neonatal head and torso vibration exposure during inter-hospital transfer.
Neonatal head and torso vibration exposure during inter-hospital transfer.
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DOI：
10.1177/0954411916680235
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
Sharkey D
中科院分区：
文献类型：
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作者：
Blaxter L;Yeo M;McNally D;Crowe J;Henry C;Hill S;Mansfield N;Leslie A;Sharkey D
由于新生儿重症监护的集中化，早产儿的医院间转运越来越普遍。然而，已知它与发病率的严重增加有关，最明显的是脑损伤，并且与多因素原因引起的死亡率增加有关。令人惊讶的是，有相对较少的以前的研究调查的水平，机械冲击和振动的危险存在于这一车辆运输路径。使用定制的惯性数据记录器和分析软件，我们量化振动和线性头部加速度。在新生儿患者和早产儿假人的前额和躯干上安装多个惯性传感单元，并在跨站点转移期间在运输保育箱的底盘上安装多个惯性传感单元，我们发现目前用于保护保育箱内新生儿的床垫和安全带系统的谐振频率为。这与车辆底盘振动耦合，增加了新生儿的振动暴露。在所研究的所有12种新生儿运输中，每次行程的振动暴露（使用ISO 2631标准的A（8））至少为现行欧盟法规行动点值的20%，在两种情况下达到70%。线性头部加速度（1015）的直接伤害风险可忽略不计。虽然整体危害相似，但海绵床垫和空气床垫的隔振效果有很大不同。使用全球定位系统数据记录器和惯性传感器，车辆速度仅在60 km/h以上时振动才会增加。这些初步研究结果表明，有可能设计出更好的系统来转移生病的婴儿，从而可能改善他们的结果。
Inter-hospital transport of premature infants is increasingly common, given the centralisation of neonatal intensive care. However, it is known to be associated with anomalously increased morbidity, most notably brain injury, and with increased mortality from multifactorial causes. Surprisingly, there have been relatively few previous studies investigating the levels of mechanical shock and vibration hazard present during this vehicular transport pathway. Using a custom inertial datalogger, and analysis software, we quantify vibration and linear head acceleration. Mounting multiple inertial sensing units on the forehead and torso of neonatal patients and a preterm manikin, and on the chassis of transport incubators over the duration of inter-site transfers, we find that the resonant frequency of the mattress and harness system currently used to secure neonates inside incubators is . This couples to vehicle chassis vibration, increasing vibration exposure to the neonate. The vibration exposure per journey (A(8) using the ISO 2631 standard) was at least 20% of the action point value of current European Union regulations over all 12 neonatal transports studied, reaching 70% in two cases. Direct injury risk from linear head acceleration (HIC15) was negligible. Although the overall hazard was similar, vibration isolation differed substantially between sponge and air mattresses, with a manikin. Using a Global Positioning System datalogger alongside inertial sensors, vibration increased with vehicle speed only above 60 km/h. These preliminary findings suggest there is scope to engineer better systems for transferring sick infants, thus potentially improving their outcomes.