Philip

I was wondering if anyone has come across a good/realistic design for a DIY incubator to be used in a rural low-resource setting to transport premature newborns to a 2nd or 3rd-level neonatal ward. Similarly, could anyone share a link for a low-cost DIY incubator to be used in a neonatal ward (not for transport). Specifically for preterms 33-34 weeks in their first 72 hours of life or for more premature babies (26-32) who are several weeks old and already weaned off respiratory support, and receiving hospital kangaroo care. Basically a design for a safe, heated low-cost DIY incubator design where a stable premature baby can avoid hypothermia while their mother is getting something to eat or getting much-needed rest. Needless to say, it needs to be able to be built with materials easily found at a good hardware store. I’m open to any ideas.

We don't have Repplogle tubes available in our country. so we have to improvise. While waiting for the surgery and stabilizing the patient we place a 5Fr orogastric tube inside a 10 o 12FR nasogastric tube. We connect the 12 FR tube to continuous suction and the 5Fr tube to saline infused at very very slow rate. This is then placed in the mouth in the proximal pouch of the esophagus. It works pretty well, the saline diluting the thick saliva so the 10 FR tube can suction it out and doesn't ever become obstructed. After surgery the patient has drainage thorax tube for approximately 3-5 days and this is then removed after the patient has been extubated (2 or 3 day after the surgery) and there is no evidence of saliva draining in the chest tube.

I am a neonatologist working in a low-income country in a hospital with 6000 + births a year. The hospital also functions as the only neonatal referral center for a region that has 17,000 births a year. Due to being a public institution the mothers of our newborns are mostly from extremely low-income households thus we have high rates of congenital malformations and premature births with the corresponding elevated rates of morbidity and mortality. We are interested in implementing Point of Care Echocardiagram for monitoring pulmonary pressure, cardiac function and PAD as well as implementing Point of Care Ultrasound for pleural effusions, line placement, and to perform transfontanellar ultrasound. On of the cheaper options I found was the Butterfly IQ Ultrasound which connects to iphones and Ipads. While i have talked to other medical practitioners in other countries about their positives experiences in pediatric patients using the Butterfly IQ, I have not come across someone with experience using the Butterfly IQ in neonatal patients. I would welcome any feedback pertaining to this topic and welcome other affordable solutions of POCUS that can be used in the neonatal population.