DE20114157U1 - Device for receiving an infant - Google Patents

Description

Johannes Hoyer August 21, 2001

Celtic Trail 3
35745 Herborn

Device for holding an infant Description

The invention relates to a device according to the preamble of claim 1.

It belongs to the field of incubators, warming beds, infant lying devices and infant positioning aids.
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It is known to use incubators or warming beds for the medical care and intensive medical care of infants, especially premature babies.

State of the art

Today’s state-of-the-art incubators usually have the following features:

- the device for holding an infant (premature baby) is closed at the top. The upper part / hood is mainly made of transparent material.

- have side openings and/or the upper part can be opened.

- the size is such that it can not only accommodate the child, but also that the child can be handled within the incubator and there is additional storage space.

- To ensure even temperature distribution, some devices are equipped with a double-walled hood.

- have a device that generates warm and/or humid air, which then flows into the interior (the child's lying area) via ventilation slots using a fan.

- the moist air is usually produced by evaporation and/or fine atomization of water. The air is usually heated using a rigid electrical conductor through which current flows, which then produces heat due to the resistance of its own material. The air is passed past this, it absorbs the heat and is then led into the incubator's lying chamber.

- the air supplied to the interior can also be enriched with oxygen. The incubator draws the oxygen externally via a supply line.

- the lying surface on which the baby lies can be tilted lengthwise.

- on some devices, the lying surface can also be tilted transversely and/or moved or pulled out sideways.

- other medical supplies (e.g. active ventilation, infusions, etc.) are supplied to the child from outside via tubes and lines. This means that these are not part of the incubator.

- the incubator is on a frame / substructure / support. This holding device allows the incubator to be placed at different heights.

- The support is equipped with wheels that allow the unit to be moved or transported.

Such incubators in various designs or parts thereof can be found, for example, in the following publications:

DE 69103302 T2 950614 DE 69106020 T2 950504 (US 900326 499091) DE 4390794 T1 950223 (US 920227 842455) DE 3616359 A1
DE 19526103 A1 970130 DE 03503418 C2 920716 DE 09402602 U1 940804 DE 19737149 A1 980305 (US 960827 703793) DE 19916890 A1 20000531 DE 196177 39 C1 970612 DE 19725498 C1 981015

In addition to the well-known incubators, warming beds are also used in the medical care of infants.

The well-known warming beds are usually characterized by the following:

- are devices that are open at the top and have a flat lying surface.

- have side walls that can be folded away or removed. These walls are usually made of a transparent material.

- generate heat underneath the infant pad. Between the infant and the heat source there is a kind of mattress filled with gel or water. The generation of the

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Heat is generated by a flat, level heat source underneath the mattress. The heat is transferred to the child via the mattress by convection.

- generate heat above the baby, i.e. heat radiators are installed above the baby. The lying surface (or the baby) is thus radiated with heat from above.

- the lying surface on which the baby lies can be tilted lengthwise.

- on some devices, the lying surface can also be tilted transversely and/or moved or pulled out sideways.

- other medical supplies (e.g. active ventilation, infusions, etc.) are supplied to the child from outside via tubes and supply lines. This means that these are not part of the warming bed.

- the heating bed is on a frame/substructure/support. This holder is height adjustable, so the heating bed can be set to different heights.

- The support is equipped with wheels that allow the unit to be moved or transported.

DE 19608955 A1 970911, for example, shows a heated bed with a rod-shaped heat radiator that is arranged above the lying surface.

It is also known that small nests made of textile material are formed to better support babies in incubators or warming beds. There are also some pre-formed nests or bulges that are used for this purpose in hospitals. They sometimes resemble a curved bulge or a bent tube. They are usually made of textile material on the outside and filled with a soft, elastic material on the inside. So-called positioning horns are also known, which are U-shaped and, when positioned together, form a type of nest; each U-shape forms a head or foot section and the ends of the horns are therefore on the long side of the baby. It is also known that these positioning horns contain air chambers that can be manually inflated or adjusted.

Furthermore, various devices are known which relate to the positioning of the infant in the incubator and/or are intended to provide the infant with supportive stimuli. ·

This includes, for example, DE 09402601 U1 940804, a type of air cushion for bedding premature and normal babies.

DE 09307341 U1 940310 shows, for example, an elastic suspension device that encloses the child from the side, thereby replacing the bedding on a lying surface in a stretched-out position.

DE 20006758 U1 20000907 shows a hammock that is stretched out in the incubator. JP 960131 37283/96 (or DE 19702672 A1 970807) describes a mat device for the incubator. This contains a base with internal electromechanical vibration converters, on which there is a mat on which the baby is laid. A sound signal generator can thus provide comfortable vibrations to the newborn child.

US 890929 415064 (or DE 69018181 T2 951109) also shows, for example, a system with which certain vibrations / movements can be transmitted to a newborn in the incubator.

In addition, there are various other approaches to the medical care and treatment of premature babies or infants.

DE 19514387 C2 990520, for example, shows a suit for infants, especially premature babies, which is thermally insulating, impermeable to water vapor from the inside to the outside and intended for use inside and outside the incubator.

DE 19855262 A1 990715 shows a reclining device with a hood that partially encloses the child's head area. This known device has a sleeping bag in which the infant lies. The sleeping bag has various channels or cavities to accommodate a heating device. In addition, the sleeping bag and/or the reclining device can be hung up.

DE 19753240 A1 990602, for example, describes a passive baby bed for attachment to the long side of a hospital bed. This baby bed is open on the side closest to the hospital bed, which makes it easier to access the baby.

The use of electrically conductive fiber plastic, in particular carbon fiber fabric or carbon fibers, for heat generation is known from the following documents DE 4221455 A1 and DE 4233118 A1.

DE 19642037 C2 also shows a heating blanket with an electrically operated resistance heating layer, which is essentially made only of carbon fibers that are processed into a flat, flexible fiber fabric.

From DE 19853249 A1, a composite textile for rescue operations with an outer water-repellent layer and an inner heat-insulating layer is also known, wherein a controllable heating device, preferably made of carbon mesh, is applied to the inner heat-insulating layer.

DE 29905933 U1 describes a heat-generating article for a body part, with a basic structure that is, among other things, positively adapted to the body part and in which a heating device is integrated that preferably generates active heat using carbon fibers.

High-tech clothing fabrics are also well-known, which are made from a specially developed synthetic fiber with a raised surface, particularly polyester. The larger surface of the individual fiber is achieved by the formation of small channels on the fiber surface, for example also known as four-channel fiber. These channels increase the transport of moisture or water along the fiber and thus in the fabric. This material therefore conducts and distributes the water more quickly. A better distribution of moisture in turn leads to a faster evaporation of the existing water in and on the fabric.

Textile laminates that are waterproof and permeable to water vapor are also known. These consist, for example, of a composite of stretched PTFE film and another textile material. Some of these textile laminates are used in the clothing industry and in medicine in the operating room to protect and/or cover parts of the body. Special textile laminates of this kind for the medical field are known for not only being waterproof and breathable, but also forming an effective barrier against microorganisms and germs.

Disadvantages of the state of the art

The incubators commonly used in hospitals and available on the market for infants, especially premature babies, have the following disadvantages.

They isolate the child spatially and emotionally from the parents, especially the mother, to a very great extent. The transparent hood of an incubator allows a view of the child, but at the same time it isolates it from the sound of the mother's voice, the mother's smell and close skin contact with the mother. The openings are usually on the side and only allow contact with the hand. Close and increased skin contact with the mother is thus excluded. However, it has long been medically and psychologically proven that close, extensive skin-to-skin contact between infant and parents increases the well-being of both.

In order to make this possible to a certain extent, many clinics now use what is known as "kangaroo care". The mother usually sits or lies in a chair, armchair or on a couch near the incubator. The infant or premature baby is placed on her bare chest or stomach for close cuddling. To do this, the child must be lifted out of the incubator. This is often difficult because the cables from the monitoring devices to the child sometimes have to be disconnected for a short time.

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or carried along. In addition, the air gap between the child's lying surface in the incubator and the mother's chest is usually more than a meter. This means that the nursing staff has to lift the premature baby out, and the child is carried through the air by someone else's hand before it finally finds rest on the mother's stomach. This journey means additional stress for this very sensitive creature. Any stress, in turn, has a negative effect on the baby's recovery. Furthermore, the staff and the mother or father need to be very careful when transferring the premature baby to the mother's stomach, particularly so as not to accidentally tear off the leads (e.g. from the ECG, pulse oximeter, etc.) or create a tangle of cables. It is also more difficult if the child is intubated for ventilation. This ventilation tube is larger, heavier, and more rigid than the electrical leads. This makes it even more difficult to reach the mother during "kangaroo care" without putting too much pressure or tension on the mouthpiece of the ventilation tube. To avoid the risk of internal injury or accidentally pulling out the ventilation tube, the ventilation tube sometimes has to be briefly removed when passing it over to the mother. This in turn means an additional action and an interruption of the active ventilation of the child.

In the situation described, however, it is a condition that the mother is physically fit after the birth of the child in order to visit it in the premature baby ward. In around 50% of pregnancies that end too early, however, the child is delivered by Caesarean section. This means that the mother is weak and bedridden in the first few days after the birth. The Caesarean section also severely limits her mobility and strength in the first few days after the birth, including lifting the baby out of the womb. She usually spends the first few days recovering in the gynaecological clinic or on the maternity ward. This means that she cannot visit her child in the corresponding ward for premature babies at all or only with great effort. This leads to a lack of bonding, an inner connection, between mother and child and can, under certain circumstances, have lifelong psycho-social consequences.

When caring for the baby in a warming bed, access to the baby is better because there is no closed hood, but only side walls enclose the lying surface, but here too there is the problem of the long path from lifting it out to the mother's breast if she wants to cuddle up close to her child.

A basic problem with both known devices, warming bed and incubator, is that they are standing devices, i.e. they are primarily designed to be used in an upright position. The child's lying surface in the incubator is approximately at the belly or hip height of a standing adult. For a user in a sitting position,

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Handling and viewing the child is already more difficult; in some cases impossible when the user is lying down.

Another disadvantage of the incubators and warming beds that are commonly used is that the infant is flooded with unhealthy stimuli. In an incubator or warming bed, the child is defenselessly exposed to all the noises in the same room, including alarm signals from monitoring devices, telephone rings and loud conversations. In addition, the hood of an incubator forms a kind of sound box, with the child in the middle of it. This means that every knock or bang on the incubator housing is amplified by the hollow body of the top. If an object is placed roughly on the hood of the incubator, a haunting banging sound can be heard inside the incubator.

In incubators, the patient area is heated by circulating heated, humidified air, for example, or by using radiant heat. A disadvantage of circulating air is the high operating noise of the built-in fan or blower. This leads to further acoustic stress for the infant. Another problem is maintaining a uniform temperature inside and not drastically disturbing it when the incubator is opened for a doctor or nurse to access its interior in order to treat or care for the child.

In the well-known incubators and warming beds, for example, the lying surfaces are large, flat, level mattresses. The child is often only wearing a diaper and placed in the middle of the mattress, which offers no lateral support. This leads to a position of the legs that is problematic for babies, as they often remain stretched out. This position promotes malformation of the hips (hip dysplasia).

In addition, children in the womb always come up against spatial boundaries that make them aware of their own body and existence. If these babies are then lying on a flat surface, these boundaries are eliminated. This is a major disadvantage, because the child loses its spatial reference and can no longer feel itself and experience its body to the same extent as was possible in the womb.

Because the familiar nests or bulges made of fabric that allow the child to feel the physical limits mentioned above are used in the usual incubators or warming beds, the disadvantage of isolation between mother and child remains. Lifting the baby out of the device to the mother's breast still involves a great deal of effort and risks to the baby's health.

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The solution described in DE 19855262 A1 990715 has the disadvantage that free access to the child from all sides is not possible without difficulty, especially in the head area. In addition, the hood described therein has the disadvantage of a possible acoustic bundling of noise from the surroundings. The hood of the device shown therein can act like a funnel that bundles the sound in the center, for example at the child's head.

The solution known from DE 19514387 C2 990520, for example, has the disadvantage that as long as the child is in the described space suit, skin-to-skin cuddling with the child is not possible. There is no direct skin contact.

The device shown in DE 19753240 A1 990602 does not include any active medical care or support in the form of supplied heat, humidity or oxygen for the infant, which is a disadvantage in the intensive care medical field.

Object of the invention

The object of the invention is to provide a device for receiving an infant, in particular a premature or newborn baby, which supplies it with warmth, moisture and/or oxygen, which supports it in breathing if necessary, which allows continuous close proximity to the mother, easy relocation to the mother's upper body and easy access, in particular when the mother is in a lying position.

Solution to the task

This object is achieved by a device having the features of claim 1. 30

Advantages of the invention

An oval nest as a basic shape or bulges that surround the infant provide support and reinforce the feeling of security and orientation. The infant or premature baby can therefore feel and understand its body boundaries and can experience its own movement. The oval bulge prevents uncontrolled, nervous motor activity into the void and promotes the healthy spread-squat position of the infant's legs. This leads to the prevention of later hip joint misalignments.

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If the chambers in the bulge are filled with air or water, another advantage is created: the bulge becomes elastic, meaning that it returns to its previous shape after being pressed in. For the child, this means that if the bulge is kicked or if pressure is increased against it, it will feel a constant counterforce. This is proportional to the depth of the impression. This creates a similar feeling to that in the womb when the child kicks against the mother's stomach. The child is therefore in a more familiar environment, which reduces stress.

The nest is open at the top and allows free, uncomplicated access to the child.

Because there is no rigid hood, there is no risk of amplifying unwanted noise.

Since the child is supplied with heat, moisture and/or oxygen directly through the lying surface and the bulge, no air circulation is necessary. This means a reduced noise level due to the lack of fans etc. The heat and moisture are generated where they are provided, i.e. directly next to the child; this results in more efficient use of energy and reduces the risk of cold bridges. The baby's sense of well-being is increased because it lies close to the active heat source and thus heat is transferred through contact surfaces and heat radiation.

The combination of the various functional layers, in particular the exemplary use of a textile laminate with membrane character, creates a self-regulating system for moisture generation.

The blanket that can be used also provides warmth and moisture, or just warmth if required. The child is thus provided with medical care to a similar extent as in a closed incubator, but not as isolated. In addition, the mother can take this blanket with her when taking the child out, so that the child is also actively supplied with warmth and moisture from above when it is lying on the mother's stomach.

In addition, a chamber built into the bed surface can be filled with a fluid in pulses or in cycles to stimulate the child's respiratory reflex and thus support breathing. This may reduce the need for intubation for artificial ventilation.

By means of a suitable support, base or holding means, as described in the embodiments, the inventive device can be placed in or on the mother's bed. This enables close contact between mother and child and makes it easier to lift the child out of the device, particularly when the mother is in a lying position.

If the device is positioned correctly, the two or more chambers in the bulge surrounding the baby have the decisive advantage that the baby can be completely avoided from being lifted. For a mother who has had a Caesarean section, it is a great relief and pain relief if she only needs to pull or push her child towards her. In the first few days, it is sometimes impossible for Caesarean section patients to lift their own children. If used and positioned correctly, releasing the pressure or fluid in the chamber closest to the mother leads, for example, to a uniform horizontal plane between the upper body of the mother lying on her back and the child's lying surface. This enables the mother to pull her child onto her upper body while lying down. The transport path for the child from the lying surface to the mother is minimal, i.e. only a few centimeters. Stress and danger for the child are avoided and the cables for the monitoring sensors on the child do not have to be routed over long distances.

The procedure with the child is also simplified by the fact that, in an appropriate, exemplary design, all electrical cables and supply lines required for the device are bundled into a main line. The electrical signal lines are then also bundled from the device or lying surface to the child. Only in the immediate vicinity of the child are they distributed to the individual electrodes and sensors via a type of distributor. This makes handling easier and reduces the risk of tangling with the cables and supply lines.

The inventive device makes it possible to accommodate mother and child in one room. This has the following advantages: it increases the well-being of mother and baby, it reduces the risk of infection from other babies, the child can experience a day-night rhythm and both are not exposed to the alarms and noises of other patients and/or premature babies.

A further advantage of the inventive device is that it allows for close proximity to the mother when caring for small to very small premature babies, but also for sick full-term newborns, while ensuring that vital functions are monitored continuously. Until now, contact with parents was always possible in intensive care units or monitoring stations, but only temporarily and in a limited space.

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Another advantage is that all intensive medically relevant monitoring measures are visually pushed into the background and the mother-child contact can develop undisturbed. This prevents the occurrence of a "vulnerable child syndrome". 5

Because the device has fewer contact surfaces with the patient (infant) than a bulky incubator, another advantage arises: the number of surfaces and housing parts that need to be disinfected is reduced.

Examples of implementation

Embodiments of the invention are illustrated in the drawings and are described in more detail below.
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Show it:

Figure 1: Top view of the device for holding an infant. Figure 2: Side view of the long side of the device with support.

Figure 3: Vertical section A-B (in transverse direction) through the device with a filled

and an empty chamber.
Figure 4: enlarged section of the vertical section AB through the device,

in particular the bead and the cover. Figure 5: vertical section C-D (longitudinal) through the device with support

and supply lines.
Figure 6: Side view of the foot end of the device with adjustable, self-supporting support, which is mounted on a lying unit shown in vertical section

is positioned.
Figure 7: Side view of the foot end of the device with adjustable, non-self-supporting support attached to a vertical section

reclining unit is attached.
Figure 8: Side view of the foot end of the device with self-supporting, rollable support positioned on a reclining unit shown in vertical section.

Description of the embodiments:

Fig. 1 to 5 show an embodiment of the invention. The infant 3 is surrounded by a bulge 1. The bulge 1 is divided into two chambers 20 by the partition walls 15, as can be seen in particular in Fig. 1 and Fig. 3. One chamber 20 is located on the right and one on the left long side of the infant. In order to use the effect of the chamber lowering in practice, the mother lies parallel to her infant close to the device or the support 2. According to the embodiment shown in Fig. 2 and Fig. 5, the support 2 is a type of inwardly curved substructure to which the mother can snuggle up. In order to increase comfort for the mother, the support 2 is covered with a padded material 16. The support 2 raises the device according to the invention when it is placed in the mother's bed so that the lying surface 6 of the infant 3 is on approximately the same horizontal plane as the upper side of the upper body of the mother lying on her back. By reducing the fluid pressure or the amount of fluid in the chamber near the mother, the bead 1 on the mother's side is lowered or greatly reduced in height, as shown in region 5 in Fig. 3. Region 4 shows the bead 1 in its normal, filled state.

In the lying surface 6 there are so-called functional layers 14 which generate heat and moisture. Oxygen is supplied through small channels 9 in the lying surface 6.

An elastic, fluid-tight chamber 10 is arranged under the lying surface 6, which can be expanded in particular in a vertical direction upwards. This is connected to an external ventilator, for example, via the supply line 19. This provides the pressure to expand and contract the chamber 10 in pulses when medically necessary. This movement is transmitted to the child through the lying surface.

In Fig. 4, the structure of the functional layers 14 is shown in particular. These are a textile laminate 21, which is preferably waterproof and permeable to water vapor, a water-conducting material 22 or other means that transport and release water, a waterproof elastic layer 23, a carbon fiber layer 25, in particular an electrically heat-generating carbon fiber fabric, and an elastic fluid-tight material 25, which also forms the wall of the chambers 20 and the outside of the bead.

In an embodiment not shown, the carbon fiber layer 25 is replaced by other means for generating heat, for example by a metal conductor through which electric current flows or by supplying warm or hot fluids into the corresponding functional layer.

The individual functional layers (21 to 25) are also found in the structure of the cover 7. The cover 7 is supplied with electricity and water via the supply line 8.

There is only one main supply line 11 leading to the device, in which the following supply lines are bundled. An air or water supply line 18 for the function of the collapsible chamber 20 in the bead 1. A fluid supply line 19 for operating the chamber 10 for respiratory support. An oxygen supply line 9.1 for enriching the air with oxygen above the lying surface 6. A supply line 8.1 that supplies water and electricity for the functional layers in the lying surface 6. And an extendable supply line 8.2 for the optional cover 7. An extendable supply and data line 17 leads to the distributor 12. This bundles all the data that comes from the patient (infant 3) via the individual sensor supply lines 13. The distributor 13 is located directly next to the infant 3.

The padded fabric 16 is removable and sterilizable. Depending on the design, the device may be removable from the support.

Fig. 6 shows an embodiment in which the device V is positioned and, if necessary, fixed on the bed of the lying device 26 of the mother 35 with the help of the support 27, 28, 29. The clamp 29 is fixed to the bed and has a large, rigid surface or plate 37 on the top. The plate 37 serves as a stable base for the base 28 and prevents the device V from sinking into the mattress 36 with support. It is advantageous to integrate a device (not shown) for raising and lowering the device V into the base 28. The ball joint 28 enables the device V to be pivoted in all directions. In an embodiment not shown, a lifting cylinder is integrated in place of the ball joint 28.

Fig. 7 shows a further embodiment with a support 31 in the form of an arch made of solid material, which is attached to the lying device 26. This support 31 can be rotated about the vertical axis and can be adjusted in height by loosening the holding device 32, for example a screw.

Fig. 8 shows another embodiment in which the support consists of a rigid arch 33 and a kind of carriage 34. The device V can be easily moved by means of the rollers on the carriage 34. A brake (not shown) on the carriage 34 is advantageous for fixing it at a certain position. The locking between the rigid holding arch 33 and the carriage 34 is not shown, since known holding means can be used.

Claims (13)

1. Device for receiving an infant, in particular a newborn or premature baby, with a bulge surrounding the infant, characterized in that the bulge is divided into at least two chambers which are arranged on opposite longitudinal sides of the infant and are filled with a fluid, and that one of the chambers, in particular temporarily, has a lower fluid pressure or a lower fluid quantity than the opposite chamber. 2. Device according to claim 1, characterized in that the chambers are filled with air or water. 3. Device according to claim 1 or 2, characterized in that one of the chambers can be reduced in height. 4. Device according to one of the preceding claims, characterized in that it is open at the top. 5. Device according to one of the preceding claims, characterized in that moisture, heat and/or oxygen can be supplied through the lying surface. 6. Device according to claim 5, characterized in that the lying surface has at least one textile laminate, a water-conducting material and a carbon fiber layer. 7. Device for receiving an infant, in particular a newborn or premature baby, with a bead surrounding the infant, in particular according to one of the preceding claims, characterized in that the bead can be heated. 8. Device according to claim 7, characterized in that a heatable surface of the lying surface extends to the bead and at least partially covers it. 9. Device according to one of the preceding claims, characterized in that it is arranged on a support which is adjustable in height. 10. Device according to claim 9, characterized in that the support is height-adjustable on one side such that the device can be tilted. 11. Device for receiving an infant, in particular a newborn or premature baby, with a bulge surrounding the infant, in particular according to one of the preceding claims, characterized in that a chamber filled with a fluid is arranged below or in the lying surface, the internal pressure of which is variable. 12. Device according to claim 11, characterized in that the internal pressure can be changed regularly, periodically and/or by a control device which can be adjusted according to the condition of the infant. 13. Device according to claim 12, characterized in that the control device is influenced by measured values taken from the infant.