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Improved care and growth outcomes by using hybrid humidified incubators in very preterm infants
Sung Mi Kim1, Edward Y Lee, Jie Chen
1Division of Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Insights
Humidified hybrid incubators improved care for extremely low birth weight infants, reducing fluid intake and enhancing growth velocity. This approach also lowered the incidence of severe bronchopulmonary dysplasia (BPD).
Area of Science:
- Neonatalogy
- Pediatric Critical Care
- Perinatal Medicine
Background:
- Extremely low birth weight (ELBW) infants require precise environmental control.
- Conventional incubators may not optimally manage fluid and electrolyte balance.
- Hybrid incubators offer potential improvements in neonatal intensive care.
Purpose of the Study:
- To compare temperature, fluid/electrolyte management, growth, and outcomes in ELBW infants using humidified hybrid incubators (HI) versus non-humidified conventional incubators (CI).
Main Methods:
- Retrospective analysis of 182 ELBW infants' data.
- Comparison of body temperature (BT), fluid balance, and growth velocity (GV).
- Groups: HI (Giraffe OmniBed with high humidity) and CI (conventional incubator without humidity).
Main Results:
- HI group showed reduced fluid intake, urine output, insensible water loss, and hypernatremia.
- HI group had less electrolyte sampling and fewer packed red cell transfusions.
- HI group demonstrated higher GV, especially in infants <749g, and reduced severe bronchopulmonary dysplasia (BPD).
Conclusions:
- Humidified hybrid incubators enhance ELBW infant care by optimizing fluid balance and growth.
- Benefits include reduced fluid intake, improved electrolyte balance, and enhanced GV without affecting BT.
- Adjusting fluid intake with HI may further reduce BPD risk.
Objective:
To identify changes in temperature, fluid and electrolyte management, growth, and short-term outcome in extremely low birth weight (ELBW) infants nursed in humidified hybrid incubators (HI group) compared with a cohort of patients cared for in nonhumidified conventional incubators (CI group).
Methods:
Body temperature (BT), fluid and electrolyte balance, and growth velocity (GV) were collected retrospectively on 182 ELBW infants. The CI group included ELBW infants cared for with radiant warmers followed by an incubator without humidity. The HI group included ELBW infants cared for in the radiant warmer mode in a Giraffe OmniBed, followed by the incubator mode using high humidity.
Results:
The CI group included more multiple births (50.6%) than the HI group (35.8%; P < .05), but there was no difference in demographic characteristics. BT was similar during the first week. The HI group had less fluid intake, urine output, and insensible water loss, less maximum weight loss, and a lower incidence of hypernatremia during the first week than did the CI group (P < .05). The HI group also had a lower frequency of electrolyte sampling and packed red cell transfusion (P < .05), a higher incidence of hyponatremia on postnatal day 1 than the CI group (P < .05), and a higher GV than the CI group (15.2 +/- 5.0 vs 13.5 +/- 4.8 g/kg per day), especially among those with a birth weight of
Conclusions:
Use of a humidified hybrid incubator improved care for ELBW infants by making it possible to decrease fluid intake, improve electrolyte balance, and enhance GV without a disturbance of BT compared with conventional care. By adjusting fluid intake when using these devices, benefits may be enhanced and the risk of BPD and severe BPD may be reduced.
