Noise and Hypoxemia in the Intensive Care Nursery

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 143-145 ◽  
Author(s):  
John G. Long ◽  
Jerold F. Lucey ◽  
Alistair G. S. Philip
Keyword(s):  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Ambient Noise ◽  
Life Support ◽  
Noise Pollution ◽  
Hospital Personnel ◽  
Noise Levels ◽  
Intensive Care Nursery

Noise levels in the neonatal intensive care unit (NICU) have received intermittent attention in the pediatric literature.1-4 While risk criteria for the prevention of induced sensorineural hearing loss in adults are well established, little is known about the response of the newborn to environmental noise. The AAP Committee on Environmental Hazards3 has recommended that physicians and hospital personnel be alert to and eliminate unnecessary noise in nurseries. So far, attention has been directed primarily at incubator noise1,5 and that associated with life-support equipment.6 To our knowledge, little has been done to identify other sources of "noise pollution." We wish to report the results of measures taken in one NICU to quantitate and lower the ambient noise levels.

Reducing Noise Levels in the NICU

2013 ◽  
Vol 33 (1) ◽  
pp. 41-43
Author(s):  
Deborah Discenza
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Brain Development ◽  
Neonatal Intensive Care ◽  
Noise Pollution ◽  
Vulnerable Population ◽  
Noise Levels ◽  
The Brain

In a neonatal intensive care unit (NICU), babies are subjected to various noises. Despite best intentions, staff and visitors alike contribute to a significant amount of “noise pollution” in the unit. One father came up with a solution that is now implemented nationwide and is making a huge difference to the nerves and the brain development of our most vulnerable population—NICU babies.

Resuscitation and Withdrawal of Therapy in Pediatric Intensive Care

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 961-963
Author(s):  
RICHARD B. MINK ◽  
MURRAY M. POLLACK
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Pediatric Intensive Care ◽  
New Haven ◽  
Hammersmith Hospital ◽  
Hospital Deaths ◽  
Withdrawal Of Therapy ◽  
Haven Hospital

Although issues concerning withdrawal and limitation of life support are commonly discussed,1-6 actual practices in pediatrics are largely unknown and are limited to neonatal intensive care unit (ICU) studies. In the neonatal ICUs at Yale-New Haven Hospital and at Hammersmith Hospital, 14% and 30%, respectively, of all deaths followed withdrawal of care.7,8 In adult ICUs, limitation and/or withdrawal of therapy is common,9 and in one investigation, resuscitation was not attempted immediately before ICU death in nearly two-thirds of cases.10 Nonetheless, many physicians believe that most hospital deaths occur only after all resuscitative attempts have failed,6,11,12 and others believe that resuscitative efforts neither are indicated nor desirable in many cases.1,13

scholarly journals Incidence of hearing loss and importance of risk factors in the neonatal intensive care unit

2006 ◽  
Vol 49 (8) ◽  
pp. 845 ◽  
Author(s):  
Seung Hyun Kong ◽  
Jang Hee Kang ◽  
Kwang Su Hwang ◽  
Joong Pyo Kim ◽  
Hyeon Jung Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care

scholarly journals Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea

2020 ◽  
Vol 17 (21) ◽  
pp. 8082
Author(s):  
Kyu Young Choi ◽  
Bum Sang Lee ◽  
Hyo Geun Choi ◽  
Su-Kyoung Park
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
University Hospital ◽  
Control Group ◽  
Brainstem Response

Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.

scholarly journals Wideband acoustic immittance for assessing middle ear functioning for preterm neonates in the neonatal intensive care unit

2017 ◽  
Vol 64 (1) ◽  
Author(s):  
Nandel Gouws ◽  
De Wet Swanepoel ◽  
Leigh Biagio De Jager
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Middle Ear ◽  
Diagnostic Tool ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Brainstem Response

Background: The primary aim of newborn hearing screening is to detect permanent hearing loss. Because otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR) are sensitive to hearing loss, they are often used as screening tools. On the other hand, false-positive results are most often because of transient outer- and middle ear conditions. Wideband acoustic immittance (WAI), which includes physical measures known as reflectance and absorbance, has shown potential for accurate assessment of middle ear function in young infants.Objective: The main objective of this study was to determine the feasibility of WAI as a diagnostic tool for assessing middle ear functioning in preterm neonates in the neonatal intensive care unit (NICU) designed for premature and ill neonates. A further objective was to indicate the difference between the reflectance values of tones and click stimuli.Method: Fifty-six at-risk neonates (30 male and 26 female), with a mean age at testing of 35.6 weeks (range: 32–37 weeks) and a standard deviation of 1.6 from three private hospitals, who passed both the distortion product otoacoustic emission (DPOAE) and AABR tests, were evaluated prior to discharge from the NICU. Neonates who presented with abnormal DPOAE and AABR results were excluded from the study. WAI was measured by using chirp and tone stimuli. In addition to reflectance, the reflectance area index (RAI) values were calculated.Results: Both tone and chirp stimuli indicated high-power reflectance values below a frequency of 1.5 kHz. Median reflectance reached a minimum of 0.67 at 1 kHz – 2 kHz but increased to 0.7 below 1 kHz and 0.72 above 2 kHz for the tone stimuli. For chirp stimuli, the median reflectance reached a minimum of 0.51 at 1 kHz – 2 kHz but increased to 0.68 below 1 kHz and decreased to 0.5 above 2 kHz. A comparison between the present study and previous studies on WAI indicated a substantial variability across all frequency ranges.Conclusion: These WAI measurements conducted on at-risk preterm NICU neonates (mean age at testing: 35.6 weeks, range: 32–37 weeks) identified WAI patterns not previously reported in the literature. High reflective values were obtained across all frequency ranges. The age of the neonates when tested might have influenced the results. The neonates included in the present study were very young preterm neonates compared to the ages of neonates in previous studies. WAI measured in at-risk preterm neonates in the NICU was variable with environmental and internal noise influences. Transient conditions affecting the sound-conduction pathway might have influenced the results. Additional research is required to investigate WAI testing in ears with and without middle ear dysfunction. The findings of the current study imply that in preterm neonates it was not possible to determine the feasibility of WAI as a diagnostic tool to differentiate between ears with and without middle ear pathology.

scholarly journals A Comparison of Sound Levels in Open Plan Versus Pods in a Neonatal Intensive Care Unit

2016 ◽  
Vol 10 (3) ◽  
pp. 30-39 ◽  
Author(s):  
Karlie Ramm ◽  
Trudi Mannix ◽  
Yvonne Parry ◽  
Mary P. (Caroline) Gaffney
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Observational Data ◽  
Neonatal Intensive Care ◽  
Careful Consideration ◽  
Noise Levels ◽  
Sound Levels ◽  
Open Plan ◽  
Average Noise Level

Objective: The objective of this study was to compare the noise levels recorded in two different neonatal intensive care unit (NICU) settings: a pod and an open plan NICU located in the same hospital. Background: The NICU is a busy environment with ambient noise levels that often exceed established recommendations. This noise deleteriously affects the physiological stability and developmental outcomes of sick and preterm infants. Pods have reduced numbers of cots (in this case, 6) compared to open plan NICUs (in this case, 11), yet the noise levels in pods have not been reported. Method: This study compared real-time decibel (dB) levels in an A-weighted scale, captured continuously by sound dosimeters mounted in both NICU settings for a period of 4 weeks: a pod setting and an open plan NICU. Researchers also collected observational data. Results: The average noise level recorded in the pod was 3 dBs less than in the open plan NICU. This result was statistically significant. However, dB recordings in both areas were over the recommended limits by 4–6 dBs, with isolated peaks between 74.5 dBs (NICU) and 75.9 dBs (pod). Observational data confirmed this correlation. Conclusions: Further research to evaluate interventions to decrease the noise levels in both settings are needed, especially during times of peak activity. Staff working in these settings need to be more aware that control of acoustic levels is important in the neuroprotection of neonates. Coupling this with careful consideration to structural components and evidence-based design planning may contribute to lowering dB levels in the NICU environment.

scholarly journals MEASUREMENT OF ACOUSTIC NOISE LEVELS IN A NEONATAL INTENSIVE CARE UNIT

2015 ◽  
Vol 19 (2) ◽  
Author(s):  
Lenilce da Silva Reis Santana ◽  
Luciana Soares da Silva ◽  
Renata Rocha da Silva ◽  
João Edson Carvalho ◽  
Wesley Souza Santana ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Acoustic Noise ◽  
Noise Levels
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