Contenuto dell'articolo principale
Abstract
SCOPO: L'obiettivo di questa revisione è descrivere l'inquinamento acustico nelle terapie intensivepediatriche e neonatali, le fonti e gli effetti del rumore sui pazienti e sui professionisti sanitari e gli interventi per diminuirlo.
METODO: La revisione della letteratura è stata condotta attraverso quattro banche dati da novembre 2016 a dicembre 2016, utilizzando parole chiave variamente combinate e Mesh.Complessivamente sono stati rilevati 237 articoli. I criteri di selezione sono stati presenza di full text e pertinenza.
RISULTATI: Sono stati selezionati 43 articoli e 2 linee guida. Il problema dell'inquinamento acustico viene studiato maggiormente a partire dagli anni 2008-2009 nelle terapie intensive neonatali ed è presente in moltissimi paesi, anche se la maggior parte degli studi vengono condotti negli Stati Uniti. Molti studi rilevano livelli sonori superiori alle raccomandazioni,cercano di identificare le fonti di rumore (monitor, incubatrici, circuiti ventilatori, conversazioni delle persone) e gli effetti del rumore elevato come stress, perdita di udito, alterazione dei parametri vitali. Gli interventi per risolvere il problema includono modifiche dei comportamenti dello staff e dei caregivers, modifiche ambientali e utilizzo di apparecchiature per limitare il rumore.
CONCLUSIONI: L'esposizione prolungata al rumore può causare gravi danni a breve e a lungotermine ai pazienti ed è quindi importante il contributo del personale infermieristico percontrollarlo e ridurlo.
PAROLE CHIAVE: rumore, terapia intensiva pediatrica, perdita udito, incubatrice
ABSTRACT
AIM: The purpose of this review is to describe acoustic pollution in neonatal and paediatric intensive care units, sources and effects of noise on patients and health care professions andinterventions to reduce it.
METHOD: The literature review was carried out using four main databanks from November 2016 to December 2016 through variously combined keywords and Mesh. 237 papers were detected. Presence of full text and pertinence were selection criteria.
OUTCOME: 43 papers and 2 guidelines were selected. The issue of acoustic pollution was more intensely investigated in neonatal intensive care settings since 2008-2009; research was present in quite numerous countries, although the majority of the studies were carried out in the USA. Most studies show acoustic levels above recommended levels. Many researches attempt to identify the source of noise (monitor, incubators, ventilatory circuits, conversations) and theeffects of intense noise like stress, loss of hearing, alterations of vital signs. Interventions to address the issue involve some changes in the staff behaviour through education, drawing the attention of the caregivers to the problem, through modifications of the settings and the use of specific materials to limit noise.
CONCLUSIONS: A prolonged exposure to noise can cause serious damage to the patients in the short and long term; the contribution of the nursing staff to limit and control acoustic pollution is thus important.
PAROLE CHIAVE: Noise, Pediatric intensive care unit, Neonatal intensive care unit, Hearing loss, Infant incubator
Dettagli dell'articolo
Riferimenti
- Abou Turk, C., Williams, A.L., & Lasky, R.E. (2009).
- A randomized clinical trial evaluating silicone
- earplugs for very low birth weight newborns in
- intensive care. Journal of Perinatology, 29 (5), 358-
- Altuncu, E., Akman, I., Kulekci, S., Akdas, F., Bilgen,
- H., & Ozek, E. (2009). Noise levels in neonatal
- intensive care unit and use of sound absorbing
- panel in the isolette. International Journal of
- Pediatric Otorhinolaryngology, 73 (7), 951-953.
- Antonucci, R., Porcella, A., & Fanos, V. (2009). The
- infant incubator in the neonatal intensive care
- unit: unresolved issues and future developments.
- Journal of Perinatal Medicine, 37 (6), 587-598.
- Bellieni, C.V., Buonocore, G., Pinto, I., Stacchini, N.,
- Cordelli, D.M., & Bagnoli, F. (2008). Use of
- sound-absorbing panel to reduce noisy incubator
- reverberating effects. Biology of the Neonate, 84
- (4), 293-296.
- Brandon, D.H., Ryan, D.J., & Barnes, A.H. (2007).
- Effect of environmental changes on noise in the
- NICU. Neonatal Network, 26 (4), 213-218.
- Bremmer, P., Byers, J.F., & Kiehl, E. (2003). Noise and
- the premature infant: physiological effects and
- practice implications. Journal of Obstetric,
- Gynecologic and Neonatal Nursing, 32 (4), 447-
- Brown, G. (2009). NICU noise and the preterm infant.
- Neonatal Network, 28 (3), 165-173.
- Carter, B.S., Carter, A., & Bennett, S. (2008). Families'
- views upon experiencing change in the neonatal
- intensive care unit environment: from the 'baby
- barn' to the private room. Journal of Perinatology,
- (12), 827-829.
- Carvalhais, C., Santos, J., da Silva, M.V., & Xavier, A.
- (2015). Is There Sufficient Training of Health Care
- Staff on Noise Reduction in Neonatal Intensive
- Care Units? a Pilot Study From Neonoise Project.
- Journal of Toxicology and Environmental Health,
- Part A 78 (13-14), 897-903.
- Carvalho, W.B., Pedreira, M.L., & de Aguiar, M.A.
- (2005). Noise level in a pediatric intensive care
- unit. Journal of Pediatrics, 81 (6), 495-498.
- Chang, Y.J., Pan, Y.J., Lin, Y.J., Chang, Y.Z., & Lin,
- C.H. (2006). A noise-sensor light alarm reduces
- noise in the newborn intensive care unit. American
- Journal of Perinatology, 23 (5), 265-271.
- Chen, H.L., Chen, C.H., Wu CC, Huang, H.J., Wang,
- T.M., & Hsu, C.C. (2009). The influence of
- neonatal intensive care unit design on sound level.
- Pediatrics and Neonatology, 50 (6), 270-274.
- Darcy, A.E., Hancock, L.E., & Ware, E.J. (2008). A
- descriptive study of noise in the neonatal intensive
- care unit. Ambient levels and perceptions of
- contributing factors. Advances in Neonatal Care, 8
- (3), 165-175.
- Domanico, R., Davis, D.K., Coleman, F., & Davis,
- B.O. (2011). Documenting the NICU design
- dilemma: comparative patient progress in openward
- and single family room units. Journal of
- Perinatology, 31 (4), 281-288.
- van Dommelen, P., Mohangoo, A.D., Verkerk, P.H.,
- van der Ploeg, C.P., & van Straaten, H.L. (2010).
- Risk indicators for hearing loss in infants treated in
- different Neonatal Intensive Care Units. Acta
- Paediatrica, 99 (3), 344-349.
- Edworthy, J., & Hellier, E. (2005). Fewer but better
- auditory alarms will improve patient safety.
- Quality and Safety in Health Care, 14 (3), 212-
- Johnson, A.N. (2003). Adapting the neonatal intensive care environment to decrease noise. Journal of
- Perinatal and Neonatal Nursing, 17 (4), 280-288.
- Jousselme, C., Vialet, R., Jouve, E., Lagier, P., Martin,
- C., & Michel, F. (2011). Efficacy and mode of
- action of a noise-sensor light alarm to decrease
- noise in the pediatric intensive care unit: a
- prospective, randomized study. Pediatric Critical
- Care Medicine, 12 (2), 69-72.
- Karam, O., Donatiello, C., Van Lancker, E., Chritin,
- V., Pfister, R.E., & Rimensberger, P.C. (2008).
- Noise levels during nCPAP are flow-dependent but
- not device-dependent. Archives of Disease in
- Childhood, Fetal and Neonatal Edition, 93 (2),
- -134.
- Kaur, H., Rohlik, G.M., Nemergut, M.E., & Tripathi,
- S. (2016). Comparison of staff and family
- perceptions of causes of noise pollution in the
- Pediatric Intensive Care Unit and suggested
- intervention strategies. Noise & Health, 18 (81),
- -84.
- Kellam, B., & Bhatia, J. (2008). Sound spectral analysis
- in the intensive care nursery: measuring highfrequency
- sound. Journal of Pediatric Nursing, 23
- (4), 317-323.
- Kellam, B., & Bhatia, J. (2009). Effectiveness of an
- acoustical product in reducing high-frequency
- sound within unoccupied incubators. Journal of
- Pediatric Nursing, 24 (4), 338-343.
- Kirchner, L., Wald, M., Jeitler ,V., & Pollak, A. (2012).
- In vitro comparison of noise levels produced by
- different cPAP generators. Neonatology, 101 (2),
- -100.
- Kol, E., Aydın, P., & Dursun, O. (2015). The
- effectiveness of environmental strategies on noise
- reduction in a pediatric intensive care unit:
- creation of single-patient bedrooms and reducing
- noise sources. Journal for Specialists in Pediatric
- Nursing, 20 (3), 210-217.
- Krueger, C., Schue, S., & Parker, L. (2007). Neonatal
- intensive care unit sound levels before and after
- structural reconstruction. American Journal of
- Maternal/Child Nursing, 32 (6), 358-362.
- Lai, T.T., & Bearer, C.F. (2008). Iatrogenic
- environmental hazards in the neonatal intensive
- care unit. Clinics in Perinatology, 35 (1), 163-181.
- Lasky, R.E., & Williams, A.L. (2009). Noise and light
- exposures for extremely low birth weight newborns
- during their stay in the neonatal intensive care
- unit. Pediatrics, 123 (2), 540-546.
- Livera, M.D., Priya, B., Ramesh, A., Suman Rao, P.N.,
- Srilakshmi, V., Nagapoornima, M., ...
- Swarnarekha (2008). Spectral analysis of noise in
- the neonatal intensive care unit. Indian Journal of
- Pediatrics, 75 (3), 217-222.
- Marik, P.E., Fuller, C., Levitov, A., & Moll, E. (2012).
- Neonatal incubators: a toxic sound environment
- for the preterm infant? Pediatric Critical Care
- Medicine, 13 (6), 685-689.
- Matook, S.A., Sullivan, M.C., Salisbury, A., Miller,
- R.J., & Lester, B.M. (2010). Variations of NICU
- sound by location and time of day. Neonatal
- Network, 29 (2), 87-95.
- Meriläinen, M., Kyngäs, H., & Ala-Kokko, T. (2010).
- -hour intensive care: an observational study of
- an environment and events. Intensive Critical Care
- Nursing, 26 (5), 246-253.
- Morrison, W.E., Haas, E.C., Shaffner, D.H., Garrett,
- E.S., & Fackler, J.C. (2003). Noise, stress, and
- annoyance in a pediatric intensive care unit.
- Critical Care Medicine, 31 (1), 113-119.
- Philbin, M.K. (2004). Planning the acoustic
- environment of a neonatal intensive care unit.
- Clinics in Perinatology, 31 (2), 331-352.
- Ramesh, A., Suman Rao, P.N., Sandeep, G.,
- Nagapoornima, M., Srilakshmi, V., & Dominic,
- M. (2009). Efficacy of a low cost protocol in
- reducing noise levels in the neonatal intensive care
- unit. Indian Journal of Pediatrics, 76 (5), 475-478.
- Roberts, C.T., Dawson, J.A., Alquoka, E., Carew, P.J.,
- Donath, S.M., Davis, P.G., & Manley, B.J. (2014).
- Are high flow nasal cannulae noisier than bubble
- CPAP for preterm infants? Archives of Disease in
- Childhood. Fetal and Neonatal Edition, 99 (4),
- -295.
- Robertson, C.M., Howarth, T.M., Bork, D.L., & Dinu,
- I.A. (2009). Permanent bilateral sensory and neural
- hearing loss of children after neonatal intensive
- care because of extreme prematurity: a thirty-year
- study. Pediatrics, 123 (5), 797-807.
- Roizen, N.J. (2003). Nongenetic causes of hearing loss.
- Mental Retardation and Developmental
- Disabilities Research Reviews, 9 (2), 120-127.
- Stevens, D.C., Akram Khan, M., Munson, D.P., Reid,
- E.J., Helseth, C.C., & Buggy, J. (2007). The
- impact of architectural design upon the
- environmental sound and light exposure of
- neonates who require intensive care: an evaluation
- of the Boekelheide Neonatal Intensive Care
- Nursery. Journal of Perinatology, 27 (2), 20-28.
- Surenthiran, S.S., Wilbraham, K., May, J., Chant, T.,
- Emmerson, A.J., & Newton, V.E. (2003). Noise
- levels within the ear and post-nasal space in
- neonates in intensive care. Archives of Disease in
- Childhood. Fetal and Neonatal Edition, 88 (4),
- -318.
- Thomas, K.A., & Uran, A. (2007). How the NICU
- environment sounds to a preterm infant: update.
- American Journal of Maternal Child Nursing, 32 (4), 250-253.
- Trevisanuto, D., Camiletti, L., Doglioni, N., Cavallin,
- F., Udilano, A., & Zanardo, V. (2011). Noise
- exposure is increased with neonatal helmet CPAP
- in comparison with conventional nasal CPAP. Acta
- Anaesthesiologica Scandinavica, 55 (1), 35-38.
- United States Environmental Protection Agency (EPA)
- (2007). Information on level of environmental
- noise requisite to protect public health and welfare
- with an adequate margin of safety. Data accesso 31
- maggio, 2012, da http://www.epa.gov/aboutepa/
- history/topics/noise /01.html
- White, D., & Chair, M.D. (2007). Report of the
- Seventh Census Conference on Newborn ICU
- Design. Data accesso 30 aprile, 2012, da
- http://www.nd.edu/~nicudes/stan%2023.html
- Wubben, S.M., Brueggeman, P.M., Stevens, D.C.,
- Helseth, C.C., & Blaschke, K. (2011). The sound
- of operation and the acoustic attenuation of the
- Ohmeda Medical Giraffe OmniBedâ„¢. Noise and
- Health, 13 (50), 37-44.
- Yu, X., Gujjula, S., & Kuo, S.M. (2009). Active noise
- control for infant incubators. Conference
- Proceedings - IEEE Engineering in Medicine and
- Biology Society, 2009, 2531-2534
- Anaesthesiologica Scandinavica, 55 (1), 35-38.
- United States Environmental Protection Agency (EPA)
- (2007). Information on level of environmental
- noise requisite to protect public health and welfare
- with an adequate margin of safety. Data accesso 31
- maggio, 2012, da http://www.epa.gov/aboutepa/
- history/topics/noise /01.html
- White, D., & Chair, M.D. (2007). Report of the
- Seventh Census Conference on Newborn ICU
- Design. Data accesso 30 aprile, 2012, da
- http://www.nd.edu/~nicudes/stan%2023.html
- Wubben, S.M., Brueggeman, P.M., Stevens, D.C.,
- Helseth, C.C., & Blaschke, K. (2011). The sound
- of operation and the acoustic attenuation of the
- Ohmeda Medical Giraffe OmniBedâ„¢. Noise and
- Health, 13 (50), 37-44.
- Yu, X., Gujjula, S., & Kuo, S.M. (2009). Active noise
- control for infant incubators. Conference
- Proceedings - IEEE Engineering in Medicine and
- Biology Society, 2009, 2531-2534
Riferimenti
Abou Turk, C., Williams, A.L., & Lasky, R.E. (2009).
A randomized clinical trial evaluating silicone
earplugs for very low birth weight newborns in
intensive care. Journal of Perinatology, 29 (5), 358-
Altuncu, E., Akman, I., Kulekci, S., Akdas, F., Bilgen,
H., & Ozek, E. (2009). Noise levels in neonatal
intensive care unit and use of sound absorbing
panel in the isolette. International Journal of
Pediatric Otorhinolaryngology, 73 (7), 951-953.
Antonucci, R., Porcella, A., & Fanos, V. (2009). The
infant incubator in the neonatal intensive care
unit: unresolved issues and future developments.
Journal of Perinatal Medicine, 37 (6), 587-598.
Bellieni, C.V., Buonocore, G., Pinto, I., Stacchini, N.,
Cordelli, D.M., & Bagnoli, F. (2008). Use of
sound-absorbing panel to reduce noisy incubator
reverberating effects. Biology of the Neonate, 84
(4), 293-296.
Brandon, D.H., Ryan, D.J., & Barnes, A.H. (2007).
Effect of environmental changes on noise in the
NICU. Neonatal Network, 26 (4), 213-218.
Bremmer, P., Byers, J.F., & Kiehl, E. (2003). Noise and
the premature infant: physiological effects and
practice implications. Journal of Obstetric,
Gynecologic and Neonatal Nursing, 32 (4), 447-
Brown, G. (2009). NICU noise and the preterm infant.
Neonatal Network, 28 (3), 165-173.
Carter, B.S., Carter, A., & Bennett, S. (2008). Families'
views upon experiencing change in the neonatal
intensive care unit environment: from the 'baby
barn' to the private room. Journal of Perinatology,
(12), 827-829.
Carvalhais, C., Santos, J., da Silva, M.V., & Xavier, A.
(2015). Is There Sufficient Training of Health Care
Staff on Noise Reduction in Neonatal Intensive
Care Units? a Pilot Study From Neonoise Project.
Journal of Toxicology and Environmental Health,
Part A 78 (13-14), 897-903.
Carvalho, W.B., Pedreira, M.L., & de Aguiar, M.A.
(2005). Noise level in a pediatric intensive care
unit. Journal of Pediatrics, 81 (6), 495-498.
Chang, Y.J., Pan, Y.J., Lin, Y.J., Chang, Y.Z., & Lin,
C.H. (2006). A noise-sensor light alarm reduces
noise in the newborn intensive care unit. American
Journal of Perinatology, 23 (5), 265-271.
Chen, H.L., Chen, C.H., Wu CC, Huang, H.J., Wang,
T.M., & Hsu, C.C. (2009). The influence of
neonatal intensive care unit design on sound level.
Pediatrics and Neonatology, 50 (6), 270-274.
Darcy, A.E., Hancock, L.E., & Ware, E.J. (2008). A
descriptive study of noise in the neonatal intensive
care unit. Ambient levels and perceptions of
contributing factors. Advances in Neonatal Care, 8
(3), 165-175.
Domanico, R., Davis, D.K., Coleman, F., & Davis,
B.O. (2011). Documenting the NICU design
dilemma: comparative patient progress in openward
and single family room units. Journal of
Perinatology, 31 (4), 281-288.
van Dommelen, P., Mohangoo, A.D., Verkerk, P.H.,
van der Ploeg, C.P., & van Straaten, H.L. (2010).
Risk indicators for hearing loss in infants treated in
different Neonatal Intensive Care Units. Acta
Paediatrica, 99 (3), 344-349.
Edworthy, J., & Hellier, E. (2005). Fewer but better
auditory alarms will improve patient safety.
Quality and Safety in Health Care, 14 (3), 212-
Johnson, A.N. (2003). Adapting the neonatal intensive care environment to decrease noise. Journal of
Perinatal and Neonatal Nursing, 17 (4), 280-288.
Jousselme, C., Vialet, R., Jouve, E., Lagier, P., Martin,
C., & Michel, F. (2011). Efficacy and mode of
action of a noise-sensor light alarm to decrease
noise in the pediatric intensive care unit: a
prospective, randomized study. Pediatric Critical
Care Medicine, 12 (2), 69-72.
Karam, O., Donatiello, C., Van Lancker, E., Chritin,
V., Pfister, R.E., & Rimensberger, P.C. (2008).
Noise levels during nCPAP are flow-dependent but
not device-dependent. Archives of Disease in
Childhood, Fetal and Neonatal Edition, 93 (2),
-134.
Kaur, H., Rohlik, G.M., Nemergut, M.E., & Tripathi,
S. (2016). Comparison of staff and family
perceptions of causes of noise pollution in the
Pediatric Intensive Care Unit and suggested
intervention strategies. Noise & Health, 18 (81),
-84.
Kellam, B., & Bhatia, J. (2008). Sound spectral analysis
in the intensive care nursery: measuring highfrequency
sound. Journal of Pediatric Nursing, 23
(4), 317-323.
Kellam, B., & Bhatia, J. (2009). Effectiveness of an
acoustical product in reducing high-frequency
sound within unoccupied incubators. Journal of
Pediatric Nursing, 24 (4), 338-343.
Kirchner, L., Wald, M., Jeitler ,V., & Pollak, A. (2012).
In vitro comparison of noise levels produced by
different cPAP generators. Neonatology, 101 (2),
-100.
Kol, E., Aydın, P., & Dursun, O. (2015). The
effectiveness of environmental strategies on noise
reduction in a pediatric intensive care unit:
creation of single-patient bedrooms and reducing
noise sources. Journal for Specialists in Pediatric
Nursing, 20 (3), 210-217.
Krueger, C., Schue, S., & Parker, L. (2007). Neonatal
intensive care unit sound levels before and after
structural reconstruction. American Journal of
Maternal/Child Nursing, 32 (6), 358-362.
Lai, T.T., & Bearer, C.F. (2008). Iatrogenic
environmental hazards in the neonatal intensive
care unit. Clinics in Perinatology, 35 (1), 163-181.
Lasky, R.E., & Williams, A.L. (2009). Noise and light
exposures for extremely low birth weight newborns
during their stay in the neonatal intensive care
unit. Pediatrics, 123 (2), 540-546.
Livera, M.D., Priya, B., Ramesh, A., Suman Rao, P.N.,
Srilakshmi, V., Nagapoornima, M., ...
Swarnarekha (2008). Spectral analysis of noise in
the neonatal intensive care unit. Indian Journal of
Pediatrics, 75 (3), 217-222.
Marik, P.E., Fuller, C., Levitov, A., & Moll, E. (2012).
Neonatal incubators: a toxic sound environment
for the preterm infant? Pediatric Critical Care
Medicine, 13 (6), 685-689.
Matook, S.A., Sullivan, M.C., Salisbury, A., Miller,
R.J., & Lester, B.M. (2010). Variations of NICU
sound by location and time of day. Neonatal
Network, 29 (2), 87-95.
Meriläinen, M., Kyngäs, H., & Ala-Kokko, T. (2010).
-hour intensive care: an observational study of
an environment and events. Intensive Critical Care
Nursing, 26 (5), 246-253.
Morrison, W.E., Haas, E.C., Shaffner, D.H., Garrett,
E.S., & Fackler, J.C. (2003). Noise, stress, and
annoyance in a pediatric intensive care unit.
Critical Care Medicine, 31 (1), 113-119.
Philbin, M.K. (2004). Planning the acoustic
environment of a neonatal intensive care unit.
Clinics in Perinatology, 31 (2), 331-352.
Ramesh, A., Suman Rao, P.N., Sandeep, G.,
Nagapoornima, M., Srilakshmi, V., & Dominic,
M. (2009). Efficacy of a low cost protocol in
reducing noise levels in the neonatal intensive care
unit. Indian Journal of Pediatrics, 76 (5), 475-478.
Roberts, C.T., Dawson, J.A., Alquoka, E., Carew, P.J.,
Donath, S.M., Davis, P.G., & Manley, B.J. (2014).
Are high flow nasal cannulae noisier than bubble
CPAP for preterm infants? Archives of Disease in
Childhood. Fetal and Neonatal Edition, 99 (4),
-295.
Robertson, C.M., Howarth, T.M., Bork, D.L., & Dinu,
I.A. (2009). Permanent bilateral sensory and neural
hearing loss of children after neonatal intensive
care because of extreme prematurity: a thirty-year
study. Pediatrics, 123 (5), 797-807.
Roizen, N.J. (2003). Nongenetic causes of hearing loss.
Mental Retardation and Developmental
Disabilities Research Reviews, 9 (2), 120-127.
Stevens, D.C., Akram Khan, M., Munson, D.P., Reid,
E.J., Helseth, C.C., & Buggy, J. (2007). The
impact of architectural design upon the
environmental sound and light exposure of
neonates who require intensive care: an evaluation
of the Boekelheide Neonatal Intensive Care
Nursery. Journal of Perinatology, 27 (2), 20-28.
Surenthiran, S.S., Wilbraham, K., May, J., Chant, T.,
Emmerson, A.J., & Newton, V.E. (2003). Noise
levels within the ear and post-nasal space in
neonates in intensive care. Archives of Disease in
Childhood. Fetal and Neonatal Edition, 88 (4),
-318.
Thomas, K.A., & Uran, A. (2007). How the NICU
environment sounds to a preterm infant: update.
American Journal of Maternal Child Nursing, 32 (4), 250-253.
Trevisanuto, D., Camiletti, L., Doglioni, N., Cavallin,
F., Udilano, A., & Zanardo, V. (2011). Noise
exposure is increased with neonatal helmet CPAP
in comparison with conventional nasal CPAP. Acta
Anaesthesiologica Scandinavica, 55 (1), 35-38.
United States Environmental Protection Agency (EPA)
(2007). Information on level of environmental
noise requisite to protect public health and welfare
with an adequate margin of safety. Data accesso 31
maggio, 2012, da http://www.epa.gov/aboutepa/
history/topics/noise /01.html
White, D., & Chair, M.D. (2007). Report of the
Seventh Census Conference on Newborn ICU
Design. Data accesso 30 aprile, 2012, da
http://www.nd.edu/~nicudes/stan%2023.html
Wubben, S.M., Brueggeman, P.M., Stevens, D.C.,
Helseth, C.C., & Blaschke, K. (2011). The sound
of operation and the acoustic attenuation of the
Ohmeda Medical Giraffe OmniBedâ„¢. Noise and
Health, 13 (50), 37-44.
Yu, X., Gujjula, S., & Kuo, S.M. (2009). Active noise
control for infant incubators. Conference
Proceedings - IEEE Engineering in Medicine and
Biology Society, 2009, 2531-2534
Anaesthesiologica Scandinavica, 55 (1), 35-38.
United States Environmental Protection Agency (EPA)
(2007). Information on level of environmental
noise requisite to protect public health and welfare
with an adequate margin of safety. Data accesso 31
maggio, 2012, da http://www.epa.gov/aboutepa/
history/topics/noise /01.html
White, D., & Chair, M.D. (2007). Report of the
Seventh Census Conference on Newborn ICU
Design. Data accesso 30 aprile, 2012, da
http://www.nd.edu/~nicudes/stan%2023.html
Wubben, S.M., Brueggeman, P.M., Stevens, D.C.,
Helseth, C.C., & Blaschke, K. (2011). The sound
of operation and the acoustic attenuation of the
Ohmeda Medical Giraffe OmniBedâ„¢. Noise and
Health, 13 (50), 37-44.
Yu, X., Gujjula, S., & Kuo, S.M. (2009). Active noise
control for infant incubators. Conference
Proceedings - IEEE Engineering in Medicine and
Biology Society, 2009, 2531-2534