|Year : 2017 | Volume
| Issue : 1 | Page : 15-18
Solar powered baby/infant radiant warmer installed in neonatal intensive care unit in a Tertiary Care Hospital
Vasantha Thavaraj1, Siddarth Ramji2, Oruganti Sankara Sastry3, Nav Nidhi Sharma1
1 Indian Council of Medical Research, New Delhi, India
2 Division of Neonatal, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
3 National Institute of Solar Energy, Gurgaon, Haryana, India
|Date of Web Publication||8-Feb-2017|
Dr. Vasantha Thavaraj
Indian Council of Medical Research, Ansari Nagar, Post Box No. 4911, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
Context: Hypothermia is common in infants born at hospitals (32%–85%) and at homes (11%–92%). Hypothermia does not lead to mortality directly; it contributes globally to newborn survival mostly as comorbidity of neonatal infection, preterm birth, low birth weight babies, and asphyxia, even in tropical countries such as India. The problem of low birth infants is 30% in our country. One of the estimates of reducing neonatal deaths is to provide warmth to the baby. By giving warmth to the baby either skin to skin contact or incubator or open care system, the potential impact in reducing the neonatal deaths is estimated at 1.8%–42%. Aim: India is going through energy crisis, a solar powered baby warmer was thought of to prevent hypothermia in the newborn care. Setting and Design: An open care infant warmer was planned to connect to solar rooftop photovoltaic (PV) panels in a Neonatal Intensive Care Unit (NICU), in a tertiary hospital in New Delhi. The PV system was designed for about 10 h of working, to generate for approximately 4 kWh of energy per day. Methods: Solar panels were connected to one open care radiant warmer with an inbuilt energy meter in a NICU in a tertiary care hospital in New Delhi. Energy meter was also connected to the AC mains/grid to know if any current is drawn from the grid. Energy meter readings were taken at the time of installation of solar radiant warmer and at the end of 368 days at the end of all the seasons. Results: The solar powered radiant warmer was successfully installed in the NICU and fully functional since December 10, 2012. The preliminary energy consumption study shows that PV panels of 1.2 kWp were more than enough to run one radiant warmer. At least two radiant warmers could be connected in the panel size used. There is no running cost as the electricity saved in the 1st year was equal to the cost solar panel and cost of radiant warmer. Conclusions: The solar powered baby warmer is environment-friendly. In rural areas where power supply is erratic and where there is plenty of sunshine, this product will help in the care of high-risk infants in Level II special care newborn units in district hospital and neonatal stabilizing units in subdistrict levels at primary health center and community health center.
Keywords: Newborn survival, radiant warmer, solar, solar radiant warmer
|How to cite this article:|
Thavaraj V, Ramji S, Sastry OS, Sharma NN. Solar powered baby/infant radiant warmer installed in neonatal intensive care unit in a Tertiary Care Hospital. J Clin Neonatol 2017;6:15-8
|How to cite this URL:|
Thavaraj V, Ramji S, Sastry OS, Sharma NN. Solar powered baby/infant radiant warmer installed in neonatal intensive care unit in a Tertiary Care Hospital. J Clin Neonatol [serial online] 2017 [cited 2020 Jan 17];6:15-8. Available from: http://www.jcnonweb.com/text.asp?2017/6/1/15/199760
| Introduction|| |
The current rate of infant mortality in India is 40/1000, and two-third of it is accounted by neonatal mortality. The Registrar General of India surveyed all deaths occurring during 2001–2003 in 1.1 million nationally representative homes and found that deaths due to prematurity and low birth weight (LBW) seen in 0.33 million.
In a study by Darmstadt et al. in 2006, hypothermia was seen in 45% in the first 24–48 h of the newborns in North India. Hypothermia among newborns gives rise to neonatal morbidity and mortality in low-resource countries such as India. It was described in Lancet Child survival series II that there are 23 child survival interventions that could reduce the under-five mortality and one of the interventions being newborn temperature management.
In the Lancet neonatal survival series, extracare for LBW babies including Kangaroo mother care to reduce hypothermia will lead to reduction in neonatal mortality.
The LBW babies are prone to hypothermia (inability to maintain its own body temperature). All these metabolic states lead to severe morbidity and mortality. The LBW babies also have an unstable thermal regulation; therefore, they are not able to maintain temperature.
The disadvantage is that if the baby is very small and sick babies require oxygen, then the babies are made to lie down on the radiant warmer bed.
The World Health Organization has classified hypothermia into three grades and for each of the classification, there are guidelines in place for responding to or managing hypothermia.
The open care system of baby radiant warmer is presently being used in Indian health system. The power requirement is 220 V/50Hz. The power consumption is 400–800 W. The heating element is metal alloy wire coiled within a quartz tube electrically heated with parabolic reflector. The wattage necessary for the baby warmer is 350–750 W and with heater output adjustable from 0% to 100%. The open care system is being used in our health system, in the district hospital, community health center, and subcenter in Indian healthcare system.
| Methods|| |
Installation of solar powered radiant warmer in Lok Nayak Hospital, New Delhi
To begin with a solar power plant was installed in a tertiary care urban hospital in the city of New Delhi, on December 10, 2012. The roof above the Neonatal Intensive Care Unit (NICU) in tertiary hospital was chosen as the right place to install which was also receiving the direct sunlight.
Details of radiant warmer[Figure 1]a
A single open care system of infant radiant warmer with 400 W of infrared heating element and an energy meter, with baby bassinet was installed in the NICU, tertiary hospital. The radiant warmer was kept near the window so that the connection can be made easily with the solar panel in the roof. The thermostatic skin servocontrol device regulates radiant heat. Energy meter was inbuilt in the radiant warmer. Energy meter was also connected to the mains of the room to study the energy consumption from the grid [Figure 1]b.
|Figure 1: (a) Inbuilt energy meter in the radiant warmer (b) energy meter in the mains of the room in the Neonatal Intensive Care Unit to record energy consumption|
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Details of the power plant used
Battery Bank [Figure 2]a
Initial estimate using photovoltaic (PV) system design software indicated that a PV array capacity of 1200 WP, a battery bank of 425 Ah (~500 Ah), 24 V, and a hybrid inverter of 1 kVA will be required to operate the system very safely. Hence, the installed PV power plant consists of 6 PV modules of 200 WP each making the total array capacity of 1.2 kWp. The installed battery bank is of 24 V, 500 Ah Exide make, and a hybrid PV-mains inverter of 1 kVA capacity (Su-kam make) was installed to supply AC power to the radiant warmer unit.
|Figure 2: (a and b) Photovoltaic array capacity of 1200 WP, a battery bank of 425 Ah (~500 Ah), 24 V and a hybrid inverter of 1 kVA was installed|
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Solar panels [Figure 2]b
The system was designed based on the feedback, observations, and suggestions from the doctors. Initially, it is suggested to design a PV system for 10 h operation per day. From our measurements, it was found that the warmer consumes power anywhere from 30 to 400 W at its different modes of operation. However, about 400 W is the peak power during its full load operation. Accordingly, the present PV system is designed for about 10 h of working, the system consumes about 4 kWh (or 4 units) in a day. Therefore, the designed PV system is for approximate generation of 4 kWh of energy per day.
The solar power and also the AC current (main/grid) [Figure 3]a were connected through a Miniature Circuit Breaker as shown in [Figure 3]b.
|Figure 3: (a and b) The solar power and also to the AC current (main/grid) were connected through Miniature Circuit Breaker|
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| Results|| |
Usage solar radiant warmer
The warmer has been used for the care of very LBW babies (<1500 g), term babies who are sick and also some babies who underwent surgery. The solar radiant warmer has delivered warmth continuously as other radiant warmers in the unit run on regular electric source. It has been safe and no untoward incidents of over or under heating or electric hazards have been noted. The unit had a baby almost every day during the period reported above.
Energy consumption studies [Table 1]
The energy meter readings were taken at the beginning of the installation of the power plant and at the end of all the four seasons to know whether the installed solar panel size was enough for one infant radiant warmer. It was shown that only 0.72% was taken from the main/grid at the completion of 368 days. This showed that the solar panel of 1.2 kWp was more than enough for infant radiant warmer. The solar engineers advised that 2–3 solar radiant warmer could easily be connected.
The cost of the panel and one radiant warmer was Rs. 112,500/- (US $1607). The electricity saved during 368 days was Rs. 119,770.1/year (US $1711).
| Discussion|| |
The solar powered radiant warmer is a new device for the care of sick babies. This innovation solar powered radiant warmer will be used in Sick Newborn Care Unit Level II Nursery (SNCU), in neonatal stabilization unit in first referral unit and in the newborn corner in delivery room.
Survival of newborn human life, during the 1st month of life, is determined by stresses of intrauterine life, problems faced during delivery as well as adjustment to the new environment. As many as 66% babies die before the age of 6 months. Current infant mortality rate in India is 47/1000 live births and two-third of it is accounted by neonatal mortality. The causes of neonatal mortality in India are sepsis which accounts for more than 50% of the cases, birth asphyxia, birth injuries, LBW, and prematurity are other causes of neonatal deaths. According to the National Family Health Survey II (1998–1999), almost two-third (65%) deliveries take place at home.
The potential impact in reducing the neonatal deaths is to the tune of 1.8%–42% by giving warmth to the baby either skin to skin contact or incubator or open care system. This is being done currently with electric warming system. As in most parts of rural and even urban India, there is erratic electric supply; the solar baby warmer would be of great help in saving the lives of babies.
In the world's health and medical technology literature, this is the first time we have used the solar powered baby warmer in the neonatal nursery. The solar powered radiant warmer is environment-friendly, feasible to use, and affordable. These are particularly useful in rural areas with unpredictable supply of electricity.
India's power sector continues to play an important role in country's overall development. The Central Electricity Authority statistics predict energy shortages in the coming years, and therefore, developing alternative sources of energy for healthcare would be appropriate. India is going through energy crisis that it is appropriate for the country to look for new and renewable energy and solar energy is the readily available in this tropical country. Therefore, if this solar energy model of SNCUs in the district hospital works, then the Ministry of Health and Family Welfare could plan as a policy to introduce into other districts and also home-based care may be planned to care for the newborns in our country in future.
As we have already installed the world's first solar powered radiant warmer, which is fully operational, in Lok Nayak Hospital, an urban tertiary care hospital, it is highly feasible to set up the baby radiant warmers in the SNCUs, Level II nursery with solar power.
| Conclusions|| |
There is a global energy crisis. India is also going through an energy crisis. An idea to connect a regular radiant warmer to solar energy was conceptualized and installed in a tertiary care urban hospital. In the care of neonates in India, open care radiant warmers are used in the health system. The solar open care radiant warmer is working well in the care of new borns. The cost of the radiant warmer and solar panels can be recovered by saving electricity.
This study was funded by the Indian Council of Medical Research, New Delhi. We acknowledge the contributions of the expert committees constituted for the solar powered radiant warmer.
Financial support and sponsorship
This study was funded by the Indian Council of Medical Research, New Delhi 110 029, India.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Million Death Study Collaborators, Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, et al
. Causes of neonatal and child mortality in India: A nationally representative mortality survey. Lancet 2010;376:1853-60.
Darmstadt GL, Kumar V, Yadav R, Singh V, Singh P, Mohanty S, et al.
Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. J Perinatol 2006;26:597-604.
Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS; Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet 2003;362:65-71.
Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L; Lancet Neonatal Survival Steering Team. Evidence-based, cost-effective interventions: How many newborn babies can we save? Lancet 2005;365:977-88.
World Health Organization. Thermal Protection of New Born: A Practical Guide. Report No.: WHO/RHT/MSM/97.2. Geneva: World Health Organization; 1997.
[Figure 1], [Figure 2], [Figure 3]