IncuVive: A Modular Incubation System for the Developing World Indrias Bekerie, Annabelle Chu Yan Fui, Leeanna Hyacinth, Min Ye Shen, and Kiet Vo Department of Biomedical Engineering, Columbia University BME Senior Design May 1 st, 2012

99% of neonatal deaths occur in developing countries Hypothermia contributes up to 42% of the 4 million annual infant deaths in the developing world Millennium Development Goal #4: Reduce child mortality – Reduce under-five mortality rate by 2/3 – 38% of all under-five deaths occurs in the neonatal period Motivation: Combat Infant Hypothermia [Millennium Project, 2006] [World Health Organization, 2001] [UNICEF, 2007]

Low-resource areas lack personnel and resources (e.g. Mulago Hospital in Kampala, Uganda) – 60% of babies born premature – 2 nurses for 60 babies – 2 incubators (out of 20) are working There is a need for an infant-warming system that can both work on its own and repurpose nonfunctioning incubators. Need: Cheap and Effective Solution to Warm Infant

Current Solutions Used in the NICU Incubator Heat pad Kangaroo care [World Health Organization, 2001]

Functional Requirements and Constraints Functional Requirements Increase infant temperature to normal range of °C Maintain infant temperature for at least 24 hours Constraints Low cost Low power Easy to maintain and repair High controllability Easy to use Safe

Practical Specifications Designed specifically for low-resource settings Components can be found locally Can function as a stand-alone incubator Can repurpose non-functioning incubators Product Features Warm water circulation system to prevent overheating or burning Requires no humidification Controlled by a feedback algorithm with fail-safes Different design configurations Can have 1+ mat per system Our Solution: Warm Water Circulation Mat

Current prototype Made from readily available materials Can be switched for cheaper components found locally Final Prototype Pump Heater Outlet Inlet Mat Control Panel Reservoir

Feedback algorithm and fail-safes Arduino Comparator Relay Manual switch Heater Thermistors Feedback Thermistor T f e e d b a c k < T f e e d b a c k t a r g e t T<TcutoffT>0 °CTmat<Tmat cutoff T i n f a n t < T o v e r h e a t i n g Feedback Algorithm and Fail-Safes

Able to raise and maintain the temperature of the biofluid from hypothermic to normal temperature range. Effectiveness of Our System

Able to raise and maintain the temperature of the biofluid from hypothermic to within normal temperature range. Effectiveness of Our System +/- std err

Effectiveness of Our System +/- std err [Testing on Inubator done at CUMC, 4/26/2012, on Giraffe OHMEDA Medical Incubator]

Economic Feasibility Final Prototype cost : $98.01 Commercial cost of system: $50 Prototype Cost ComponentCost 1000W Water heating element $11.00 Tubing & Mat$14.36 Bucket & Pump$33.32 Electronics & Misc.$39.33 Total Cost:$98.01 Low power consumption – 2.3 kWh/day Equivalent using a 100 W light bulb for 24 hours Low water requirement – 1 L to fill mat – $0.01 for 10L Repair Cost: – $0.03-$11 – Water heater- most expensive component

Future Work Optimize design and minimize cost and power consumption Heating unit versatility – Multiple mats/unit Backup power Instruction manual Future Work Our modular incubation system is able to work on its own or repurpose non-functional incubators to combat infant hypothermia in the developing world.

Acknowledgements Instructors Aaron Kyle, Ph.D., Biomedical Engineering Dept., Columbia University Elizabeth Hillman, Ph.D., Biomedical Engineering Dept., Columbia University Keith Yeager Sarah De Leo (TA) David Jangraw (TA) Advisers and Consultants Lance Kam, Ph.D., Biomedical Engineering Dept., Columbia University Margaret Nakakeeto-Kijjambu, MD, Mulago Hospital Richard Polin, MD, CUMC Pediatrics Rakesh Sahni, MD, CUMC Pediatrics Helen Towers, MD, CUMC Pediatrics Yvonne Vaucher, MD, UCSD David Vallancourt, Ph.D., Electrical Engineering Dept., Columbia University