Living in a box: Understanding acoustic parameters in the NICU environment

Reuter, Christoph; Bartha‐Doering, Lisa; Czedik-Eysenberg, Isabella; Maeder, Marcus; Bertsch, Matthias; Bibl, Katharina; Deindl, Philipp; Berger, Angelika; Giordano, Vito

doi:10.3389/fped.2023.1147226

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…As previously shown in the work of Reuter et al (21), it is evident that the incubator has a significant timbral influence on the sound transmission from inside to outside (as shown in Supplementary Figure S2). This is particularly evident in the case of sound features that describe timbral brightness, such as spectral centroid, spectral roll-off, spectral spread, spectral bandwidth, the zero-crossing rate.…”

Section: Discussionsupporting

confidence: 73%

“Every breath you take”: evaluating sound levels and acoustic characteristics of various neonatal respiratory support and ventilation modalities

Stummer,

Reuter,

Czedik-Eysenberg

et al. 2024

Front. Pediatr.

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BackgroundEarly sensory experiences have a significant impact on the later life of preterm infants. The NICU soundscape is profoundly influenced by various modalities of respiratory support or ventilation, which are often mandatory early in the care. The incubator, believed to shield from external noise, is less effective against noise originating inside. The objective of this study was to evaluate the sound levels and characteristics of frequently used respiratory support and ventilation modalities, taking into consideration the developing auditory system of premature infants.MethodsTo evaluate sound dynamics inside and outside an incubator during respiratory support/ventilation, experimental recordings were conducted at the Center for Pediatric Simulation Training of the Medical University Vienna. The ventilator used was a FABIAN HFOI®.ResultsJet CPAP (Continuous positive airway pressure), whether administered via mask or prongs, generates significantly higher sound levels compared to High-flow nasal cannula (HFNC) and to High-frequency oscillatory ventilation (HFOV) delivered through an endotracheal tube. Upon evaluating the sound spectrum of jet CPAP support, a spectral peak is observed within the frequency range of 4 to 8 kHz. Notably, this frequency band aligns with the range where the hearing threshold of preterm infants is at its most sensitive.ConclusionNon-invasive HFNC and invasive HFOV generate lower sound levels compared to those produced by jet CPAP systems delivered via masks or prongs. Moreover, HFNC and HFOV show a reduced acoustic presence within the frequency range where the preterm infant’s hearing is highly sensitive. Therefore, it is reasonable to speculate that the potential for auditory impairment might be more pronounced in preterm infants who require prolonged use of jet CPAP therapy during their time in the incubator.

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Section: Discussionsupporting

confidence: 73%

“Every breath you take”: evaluating sound levels and acoustic characteristics of various neonatal respiratory support and ventilation modalities

Stummer,

Reuter,

Czedik-Eysenberg

et al. 2024

Front. Pediatr.

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The father’s singing voice may impact premature infants’ brain more than their mother’s: A study protocol and preliminary data on a singing and EEG randomized controlled trial (RCT) based on the fundamental frequency of voice and kinship parameters

Papatzikis,

Dimitropoulos,

Tataropoulou

et al. 2024

Preprint

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This article presents the study protocol for a randomized controlled trial (RCT) investigating the impact of singing on the brain activity of premature infants in the Neonatal Intensive Care Unit (NICU). The study focuses on how the differentiation of voices, as defined by the fundamental frequency (F0) shaped by biological sex and kinship, influences neurophysiological responses when measured by electroencephalography (EEG). Premature infants, who are highly sensitive to auditory stimuli, may benefit from music-based interventions; however, there is limited understanding of how voice variations between male and female caregivers, and whether they are biologically related, affect brain activity. Our protocol outlines a structured intervention where infants are exposed to singing by four facilitators - a male music therapist, a female music therapist, the mother, and the father - and includes two singing stages: a sustained note (A at 440 Hz) and a 90-second lullaby, both interspersed with silent periods to allow for baseline measurements. EEG recordings track brain activity throughout these sessions, followed by quantitative EEG (qEEG) analysis and thorough statistical computations (e.g., mixed-effects models, spectral power analysis, and post-hoc tests) to explore how these auditory stimuli influence brain function. Preliminary data from five infants show that maternal singing elicits the highest delta spectral power in all measured conditions except during the ‘lullaby song’, where paternal singing elicits the highest effects followed by the male music therapist and then the mother. These early findings highlight the potential influence of parental voices, particularly the fathers’ voice, on neonatal brain development, while the detailed study protocol ensures rigor and replicability, providing a robust framework for future research. Additionally, this protocol lays the groundwork for exploring the long-term effects of music-based interventions, with the goal of improving neurodevelopmental outcomes in premature infants through tailored auditory stimulation. (clinincaltrials.gov unique identifier:NCT06398912)

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Noise: the importance of silencing the loud NICU

Boyar,

Gennattasio

2023

Best and Safe Practices in Different Contexts of Neonatal Care

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In utero, the growing fetus is subject to low-frequency noises. However, the high-risk neonate experiences much harsher sounds in the extrauterine environment. Despite many advances, modern Neonatal Intensive Care units cannot mimic the womb environment for preterm infants. Neonates are exposed to a stressful noisy environment where sleep is frequently interrupted and physiologic consequences alter development. Undesirable noise can be generated from simple conversation, use of equipment, overhead announcements, surrounding objects, and vibration. Noise levels above the American Academy of Pediatrics (AAP) recommendation (under 35–45 decibels [dB]) are associated with adverse outcomes and hearing loss. Noise level in the NICU is an important patient safety issue and should be regularly addressed by healthcare providers. Understanding modifiable and non-modifiable noise can influence daily practices, NICU design, staff education, and unit-specific quality improvement programs.

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Living in a box: Understanding acoustic parameters in the NICU environment

Cited by 3 publications

References 33 publications

“Every breath you take”: evaluating sound levels and acoustic characteristics of various neonatal respiratory support and ventilation modalities

“Every breath you take”: evaluating sound levels and acoustic characteristics of various neonatal respiratory support and ventilation modalities

The father’s singing voice may impact premature infants’ brain more than their mother’s: A study protocol and preliminary data on a singing and EEG randomized controlled trial (RCT) based on the fundamental frequency of voice and kinship parameters

Noise: the importance of silencing the loud NICU

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