Apparatus and methods for improving health outcomes of preterm infants

Abstract

Adverse effects of pain in a premature infant, especially a very or extremely premature infant may be ameliorated by exposing the infant to stimuli comprising one or more of vertical oscillating motion simulating breathing, skin contact with an interface that mimics human skin and exposure to sounds and/or vibrations that simulate heartbeats. A device including a movable platform provides such stimuli within a neonatal intensive care incubator. The device provides simulated maternal breathing through vertical movement at a rate and speed similar to that experienced by an infant lying upon its mother's chest. It further provides simulated maternal skin interface feel as well as heartbeat sound. These simulated sensory parameters appear to have an innate calming effect upon a preterm infant that reduces the duration and severity of the infant's response to a pain event. The same stimulations may reduce occurrence of below-baseline fluctuations of brain blood oxygen content.

1 .- 154 . (canceled) 
     
     
         155 . Apparatus for calming infants, the apparatus comprising:
 a platform dimensioned to support an infant;   one or more actuators connected to the platform and operable to move the platform in at least a vertical direction with an oscillating motion; and   a controller connected to control the actuators to move the platform to oscillate in the vertical direction at a frequency in the range of  5  to  25  oscillations per minute and at an amplitude of oscillation;   at least one sensor connected to provide an output signal to the controller, the at least one sensor comprising one or more sensors selected from:
 a blood oxygen sensor connected to supply a blood-oxygen signal representing blood oxygen content to the controller wherein the controller is configured to control one or both of the frequency and amplitude of oscillation of the platform based on the blood-oxygen signal; and 
 a heart monitor sensor associated with a signal processor configured to process an output signal of the heart monitor signal to yield a HRV signal indicative of heart rate variability wherein the controller is configured to control one or both of the frequency and amplitude of oscillation of the platform based on the HRV signal. 
   
     
     
         156 . Apparatus according to  claim 155  wherein the amplitude of the oscillations of the platform comprises a total vertical displacement in the range of ½ to 2 cm at a geometric center of the platform. 
     
     
         157 . The apparatus according to  claim 155  wherein the at least one sensor comprises the blood oxygen sensor. 
     
     
         158 . The apparatus according to  claim 157  wherein the blood oxygen sensor comprises a transcutaneous near infrared spectroscopy (NIRS) sensor. 
     
     
         159 . The apparatus according to  claim 157  wherein the controller is configured to adjust the amplitude and/or frequency of the oscillations in response to the blood-oxygen signal representing a change in the blood oxygen content. 
     
     
         160 . The apparatus according to  claim 159  wherein the controller is configured to adjust a length of time during which the platform is moved to oscillate based at least in part on the blood-oxygen signal. 
     
     
         161 . The apparatus according to  claim 159  wherein the at least one sensor comprises the heart monitor sensor and the controller is configured to adjust the amplitude and/or frequency of the oscillations in response to a change in the heart rate variability indicated by the HRV signal. 
     
     
         162 . The apparatus according to  claim 161  wherein the controller is configured to adjust a length of time during which the platform is moved to oscillate based at least in part on one or both of the blood-oxygen signal and the HRV signal. 
     
     
         163 . The Apparatus according to  claim 160  wherein the heart monitor comprises an ECG system. 
     
     
         164 . The apparatus according to  claim 155  wherein the at least one sensor comprises the heart monitor sensor and the controller is configured to adjust the amplitude and/or frequency of the oscillations in response to a change in the heart rate variability indicated by the HRV signal. 
     
     
         165 . The apparatus according to  claim 164  wherein the controller is configured to adjust a length of time during which the platform is moved to oscillate based at least in part on the blood-oxygen signal. 
     
     
         166 . The apparatus according to  claim 155  comprising a scheduler wherein the controller is configured to automatically initiate moving the platform to oscillate in response to an event scheduled in the scheduler, wherein the controller is configured to control the one or more actuators to oscillate the platform for a length of time following each pain event in the stored schedule of a plurality of pain events, wherein the length of time is at least in part based on the HRV signal. 
     
     
         167 . The apparatus according to  claim 155  comprising user interface providing controls operative to receive input from a user to alter operating parameters used by controller, the controls including at least a control operative to adjust the frequency of the oscillations. 
     
     
         168 . The apparatus according to  claim 167  wherein the controls include a control operative to set a pattern of the motion of the platform to combine vertical and rocking motions. 
     
     
         169 . The apparatus according to  claim 167  wherein the user interface provides a control operative to set a timer to turn on the oscillation of the platform at a certain time and/or for a certain duration. 
     
     
         170 . The apparatus according to  claim 155  wherein the controller is configured to monitor outputs of the at least one sensor and to trigger warning or alarm signals in response to the heart rate variability indicated by the HRV signal or the or blood oxygen content indicated by the blood-oxygen signal. 
     
     
         171 . The apparatus according to  claim 155  comprising a sound and vibration transducer wherein the controller comprises a memory storing pre-recorded digitized heartbeat sounds and the controller is connected to drive the sound and vibration transducer with the pre-recorded digitized heartbeat sounds from the memory. 
     
     
         172 . The apparatus according to  claim 171  wherein the sound and vibration transducer is mounted to the platform. 
     
     
         173 . The apparatus according to  claim 171  wherein the controller is configured to control sounds delivered by the sound and vibration transducer based at least in part on one or both of the HRV signal and the blood-oxygen signal. 
     
     
         174 . The apparatus according to  claim 155  comprising an incubator housing wherein the platform is contained within the incubator housing and the apparatus comprises systems for maintaining a set temperature and humidity within the incubator housing.