DESIGN A LOW COST NEONATAL INCUBATOR

Daniel Ruscansky, David Vecchione, Ryan Foley

Shankar Krishnan, Ph.D., and Mansour Zenouzi, Ph.D., P.E.
Electronics and Mechanical Department
Wentworth Institute of Technology
Boston, MA 02115

Abstract:
Babies born prematurely are generally kept in special chambers referred to as incubators,
which are enclosures with controlled temperature and humidity. Some newborn babies at the full
term also need to be placed in the incubators for special treatment purposes. Since the
introduction of neonatal incubators, the survival rate of premature births and newborns has
increased significantly, making the incubators extremely important devices in neonatal care at
hospitals. Modern incubators are very expensive making it difficult for hospitals, especially
small ones, to procure them especially with economic crunch and resource constraints for capital
equipment. The paper provides the details of a students project to design and build an efficient
and cost-effective incubator to meet the clinical needs at low budget hospitals. The design
involves controlling the temperature precisely within a small physiological range, while
concurrently maintaining the desired humidity. The incubator is also designed to trigger alarms
in the event of failures of electromechanical nature. It is noted that the project is carried out as a
part of the requirements for the Thermal Design course in the Electromechanical Engineering
program.

Introduction:
A neonatal incubator is a device consisting of a rigid box-like enclosure in which an infant may
be kept in a controlled environment for medical care.[3] The device may include a heating
element, a fan for forced convection, a water bath to add humidity, a valve through which
oxygen may be controlled, and access ports for nursing care.[3] Another type of incubator is the
neonatal transport incubator which can be used to safely transport a baby to different rooms of a
hospital or even outside during an emergency. If the infant is born with complications it can be
put in a neonatal intensive care unit (NICU). NICUs were developed in the 1950s and 1960s by
pediatricians to provide better temperature support, isolation from infection risk, specialized
feeding, and access to specialized equipment and resources. [3]
In infants born before 31 weeks gestation, evaporative water loss is the single most important
channel of heat loss. [3] This is due to a loss in moisture of the skin cells, which allows a high
permeability of water to the skin. The permeability drops rapidly in the first 7 to 10 days after
birth unless the skin becomes traumatized or secondarily infected.[3] In that 7 to 10 day period,
the absolute humidity must be monitored so that evaporative heat loss is kept to a minimum as
well as water loss through the skin.[3] The current way to monitor the baby's temperature is with
a thermistor and a controlled heating unit, but it cannot account for the water lost through the
skin, which is critical to maintain for the first 7 to 10 days after birth to prevent dehydration.[3]
Prematurely born babies often have difficulty regulating their body temperature this can lead to
organ failure; neonatal incubators are an important device for reducing infant mortality. The goal
of this project is to design an efficient and cost effective neonatal incubator.
Background:
Over the years, as medical technology has improved and more designs have surfaced, but there
are still only a few models out there. Small companies come out with different design concepts,
but they are still expensive. As the technology improves, the prices also increase, making it
extremely difficult for developing countries, and small hospitals to afford these pieces of
equipment. In past years several recalls of neonatal incubators were initiated in United States,
due to multiple reasons including heater vent door on neonatal incubator may malfunction,
medical device malfunction may affect instrument's calibration and alarm systems, neonatal
incubators and beds may unintentionally move from a safe position following an interruption in
the power supply[2] and the power board which controls the incubator heater may not regulate
the temperature properly resulting in a high temperature alarm and a loss of temperature control
within the patient compartment.[2] Modern Incubators are expensive, costing upwards of
$40,000 or even higher. [8] Some state-of-the-art models may have accessories like built-in xray machines and rotating mattresses. [8]
Between January 1st 2007 and May 16th 2008, FDA has received several adverse event reports
involving neonatal incubators. In August 2008, a summary report describing adverse events with
neonatal incubatory was issued on the Medical Product Safety Network Web Page and reported
device problems which include: The power cord of the incubator was loose and the plastic
molding around the plug of the ac power cord was melted [2] and The AIR Mode was being
used to preheat the incubator, and when the infant was placed back, the bed was not put into
baby mode. This caused the incubator to maintain an air temperature of 41.7C. This elevated air
temperature resulted in an increase of the infant's axillaries temperature.[2] Whether it is careless
error or machine malfunction, safety is the upmost importance and must be looked into for every
calculation.

Design:
The design is a safe, user friendly, and the housing is easily accessible. Despite the fact that
there are a lot of sensors, alarms, and other features associated with this incubator, it will be
relatively self sufficient. The control system will enable the temperature to reach steady state, at
the desired temperature with minimal error, and maintain a temperature until it is manually
changed, or one of the sensors detects that it needs to be changed. There will also be four ports
for accessibility, two on each side of the housing. This will ensure that the staff has access to the
baby without opening the front window, thus there will be minimal heat loss, saving money in
operation. There is also a handle on the front, allowing the top half of the design to lift up for an
easy way to access and the housing and attend to the babys need. The approximate cost to build
a full model this design is between $750 and $1000.
Temperature Control:
The main source of heat for this design is convective heat transfer via an inductive coil. To
monitor the temperature inside the housing, a thermistor is being used. The temperature of the
housing will be kept at 34oC, which is within the range of the thermsitor. [6]
Air Flow:
A low noise fan will be used for convective heat transfer, circulation of oxygen, and as a
humidifier in the housing. A low noise fan is generally less than 16dB, with a volumetric flow
rate of 0.017m3/s [10]. Not only are these fans able to deliver a high enough flow rate without
being too loud, but they can be purchased inexpensively. The velocity of these airs should be less
than 0.35m/s, to the baby is not uncomfortable. There is also a small hole in the center of the
bottom panel; this hole is used for wires, and the tubing for oxygen. There is also a ventilation
outlet, so that the air has somewhere to go when there is new air being pumped in.
Sensors:
Sensors are an extremely important aspect of any piece of medical equipment. Thermistors are
being used to monitor the temperature, because of their range and accuracy. Infants need a high
level of relative humidity, to keep the moisture from evaporating from their skin. A baby can
lose one fifth of their body mass from evaporation alone [1]. To keep the relative humidity at such
a high level; approximately 80% of relative humidity, closed loop wick and reservoir system will
be used. This system uses a fan to blow air through a wet filter, transporting the water in the air.
Another important measure to consider is an infants weight; they can gain almost an ounce a
day for the first couple months of life. To monitor this weight gain, four strain gauges are placed
under the mattress that the infant is resting on in the incubator. The deformation of these strain
gauges is directly related to a weight. This sensor will inform the nurses, doctors, and other
hospital staff if the baby is developing normally.
A pulse oximeter, and a temperature sensor on the babys skin will also be part of this system.
The percentage of oxygen needs to be monitored in the housing, and also in the baby, along with
the heart rate. The heart rate and oxygen levels are monitored by a pulse oximeter. The pulse
oximeter makes sure the babys oxygen saturation levels stay between 92% and 100%, and the
heart rate stays between 100 and 160 BPM [9]. These sensors can be found to be as accurate as
0.1% for the oxygen saturation level, and 1BPM for the heart rate.
There will also be another temperature sensor on the babys skin, to make sure that the baby is
not either too warm or too cool. A babys temperature should be kept between 36oC and 37oC.
Anything below 36oC and above 37.5 oC would trigger a sensor, causing the heating system to
adjust and get the temperature back into the normal range. [4].

Even though hospitals come equipped with generators that kick on in less than ten seconds when
there is a power outage, a power failure sensor is equipped on this design. If there is a power
failure, either from a power outage or the circuit breaker is tripped, the incubator becomes
unplugged, the sensor will recognize this. A CMOS battery will be equipped in all of the active
machines to ensure that the current settings will not be lost in the case of a power outage.
A sensor for smoke will also be part of this design, as a safety measure to prevent injury and
damage from fire in the hospital.
All of the data collected from the alarm systems will be stored on a microprocessor, so that the
incidents when the alarm systems were needed can be evaluated and fixed to prevent future
problems.
The parameters of this design are shown below in Figure 1. The Height is referring to the radius
of the round cross section plus the height of the base. The design parameters were established
upon researching the average size of a newborn baby, the needs of a newborn baby, and the
safety standards of the ANSI, AAMI, FDA, and all other applicable associations.
Design Parameters
Height
365mm
Length
800mm
Width
460mm
Inside Temperature
343C
Inside Air Velocity
< 0.35m/s
Thermistor
Range: -100C to 300C
Accuracy: Heart Rate
Pulse Oximeter
1 BPM
Accuracy: Oxygen
Saturation 0.10%
HEPA Filter
Efficiency: 99.995%
Table 1 ~ Design Parameters

Figure 1 ~ Basic Design of Incubator Housing

Figure 1, as seen above is a skeletal design for the housing of the incubator; this design does not
show the sensors, alarms systems, wires, tubing, and user interface. The wires and tubes come
through a hole in the bottom, underneath the raised platform that the mattress is on. There are
three small heating elements all located on the bottom face; there will be one centered on each of
the sides, and one on the far end. This will help to evenly distribute the temperature. The shape
of the housing also helps in an even temperature distribution. In a rectangular cross section, the
air in the corners is virtually useless, as it does not contribute to the convective process or help
the system to maintain a constant temperature, where as in a circular or semi-circular cross
section in this case, there are no corners for air to become trapped and wasted. The circular
design also allows light to pass through it more evenly. For babies with jaundice, phototherapy is
preformed. This phototherapy involves blue florescent lights that give off a certain wavelength
that breakdown the chemical known as bilirubin so that it can be excreted from the body. The
ability for light to easily pass through the Lexan is essential since the lights will not be housed in
the incubator, but outside of it.
Safety Features:
Safety is one of the most important aspects of this design; the FDAs and all other applicable
associations standards are being followed. All of the sensors listed above are connected to an
alarm system, alerting the hospital staff when something is wrong and should be investigated.
A fire retardant coating will be applied to the incubator and cables to prevent the spread of fire
and damage. There is an alarm for temperature change, if the temperature inside of the housing
increases too quickly after steady state is reached, the hospital staff will be notified. Also if the
temperature of the housing drops below 30oC, or rises above 37oC, an alarm will be activated.
Other alarms in this system are for monitoring the percentage of oxygen in the air to prevent it
from dropping below a healthy level. There are also a set of alarms monitoring the baby,
including heart rate, oxygen saturation, and weight.
There is a set of restraints in the housing for the baby, to ensure that he/she doesnt roll of the
mattress. This will prevent any injury to the infant and also unnecessary damage to the
equipment.
There will be a weight limitation for the design, taking into account the average weight of babies.
The maximum weight of the incubator will be 15kg. The heaviest baby recorded was about
10.8kg, the incubator will could hold that, and still be safe [5].
All of the air inside the housing of the incubator will first be filtered using a high efficiency
particulate absorbance filter (HEPA filter). These filters have an efficiency of 99.995%, which is
very high. HEPA filters also use high intensity ultra violet lights to kill bacteria and viruses
caught in the filter itself.
Materials:
The main power source for this design is going to be 120VAC at 60Hz; this will make
integration of these into hospitals seamless. Three small inductive coils will be used to heat the
housing. This will be more cost efficient to run than having one large coil, and it will also give a
better temperature distribution in the housing.. As for cooling, the oxygen and air from the
humidifier can be conditioned to be a cooler temperature, lowering the temperature of the
housing.
All the electronics will be located underneath the housing to improve the efficiency of the
design. The housing will be designed out of a medical grade lexan. Lexan is a lightweight,
transparent, polycarbonate, with a relatively low value of thermal conductivity [7]. The wires for
the sensors and gas control will come through a hole in the lexan housing. Each sensor and gas

tube will only fit with one color coded connecter. This will ensure that there is no confusion
about how each sensor is connected. These connectors will either be reusable or disposable
depending on the budget. .
There will also be less expensive system offered with just the basic sensors, such as temperature,
oxygen, and humidity. This will help countries in need of better medical equipment, but without
the funding to buy some of the more expensive stuff on the market currently.

Data:
The data shown below in Table 2 is an example of a newborn babys parameters. This data was
used to approximate the surface area of a baby, and calculate the heat generated by a baby.
Example
Parameters of baby
Baby
Mass, m, kg
3.1
Length, l, m
0.508
Age, p, days
1
2
Skin surface area, A x , m
0.0378
Skin Evaporation, ml/kgh
3
Table 2 ~ Data of a New Born Baby

Ax = 0.007814m 0.425 lcm

.

0.725

) = .0378m

Q m = Q con + Q cov + Q rad + Q evp

.

Q m = 0.0533(m)( p ) + 1.64 = 1.802W

Results:
Modeling the system as a second order approximation, the time it takes for the temperature to
reach steady state, and the percent overshoot can be calculated. Shown below in Figure 2 is a
model of the second order system.

Figure 2 ~ Second Order Approximation of Incubator Temperature Control

Figure 2 ~ Temperature Control Model Output

The overshoot of temperature will be adjusted to be as close to 0% as possible. This will be done
with the design of a controller.
The heat loss per unit area of the housing of the incubator system was calculated to be 1.56 .
The total surface area was calculated as 2.63 , making the total value for heat loss 4.13W.
Conclusion:

This paper includes a design for a neonatal incubator that can be manufactured and operated at a
lower cost than current designs on the market. The proposed design is a preliminary prototype
that is undergoing testing before a full scale model is built. The building of this model is
currently in progress. There are various factors that need to be taken into account during this
design process, such as the babies safety, the efficiency of this incubator compared to the
efficiency of the current market incubators, and the cost of this incubator compared to the current
market incubators. There is one basic model which only includes the necessary sensors, and then
there is a more expensive model that has all of the sensors and alarms systems mentioned. The
necessity for this design is evident because the price for not just incubators, but all medical
equipment is very high and can be lowered.

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