The rise in demand for the adoption of wireless sensor networks and automated health monitoring and alert systems is fueling researches to cater to the needs of contact-free monitoring in NICU.

With the strides in technological of innovations, continuous improvements in the existing neonatal care equipment, and government initiatives to provide affordable neonatal care, the neonatal equipment industry is unveiling new heights. Changes in regard to regulatory protocols, preventive care, reimbursement models, healthcare digitization, patient interests, physician preferences, and executive priorities are giving a momentous boost to the market. The neonatal equipment market needs affordable technologies that can conveniently reach and cater to customers in the low-income settings and assist in disease monitoring through diagnostic applications or mobile phones. Toward this end, several low-tier and mid-tier companies are developing low-cost equipment for rapid diagnosis in acute care settings.

Emerging demands and an informal collaboration of neonatologists, engineers, and entrepreneurs have led to the production of good-quality equipment of several high-volume categories at affordable cost in India. Radiant warmers, resuscitation bags, phototherapy units, weighing scales, and other devices manufactured by small-scale Indian companies have enabled an expansion of neonatal care in the country, particularly in district hospitals, medical college hospitals, and sub district facilities in the public sector as a part of the National Health Mission.

Gradual improvements in the neonatal care equipment have reduced the mortality rate to a large extent. Preterm infants are now protected using a double-walled servo-controlled incubator, and more sophisticated mechanical ventilators are used with built-in algorithms guaranteeing that even the smallest tidal volumes can be delivered in a safe manner.

Ultrasound and MRI have stemmed up as the promising imaging modalities for fetal imaging. Ultrasound technology has dramatically improved in quality and pixilation alongside dynamic valuation of flow and reconstruction of multidimensional structures yielding an enhanced sensitivity for diagnosing common fetal malformations. Improving ultrasound technology offers remarkable precision for image-guided fetal intervention Techniques. The development of ultra-fast MRI has led to significant advances in fetal imaging. Ultrafast MRI technology helps acquire an MRI sequence in 20 seconds, eliminating the need for fetal immobilization during MRI. Advances in imaging technology and the approach of combining ultrasound with fetal MRI in prenatal evaluations have led to improved accuracy and precision in the early diagnosis of congenital malformations. As minimally invasive techniques and equipment evolve, the indications for fetal therapy are likely to expand.

In the era of sensor technologies and wireless communication where remote monitoring and telecommunication have become a part and parcel of the healthcare industry, the existing technologies in neonatal intensive care unit (NICU) still face the limitation of tangling wires over the neonates. The rise in demands for the adoption of wireless sensor networks and automated health monitoring and alert systems is fueling researches to cater to the needs of contact-free monitoring in NICU.

Research Updates

The healthcare industry'sshift toward value-based careis reflected by neonatal care equipment manufacturers' interest in providing high-end, technology-integrated, home-based infant care, and neonatal solutions. Maintaining the patient–physician, point-of-care continuum, having access to solutions that provide information technology integration, wireless monitoring, and telehealth/telemedicine capabilities, opens up tremendous opportunities for neonatal care equipment manufacturers.

Wireless sensors. The concept of replacing the wired connections in the neonatal intensive care unit with wireless sensors and monitors is evolving with the increase in awareness of wireless sensors network and cloud computing and the adoption of wearable sensors and remote monitoring in the healthcare industry.

The ongoing researches focus on designing an automated heath monitoring system using sensor mobile cloud computing. These systems automatically detect hypothermia, hyperthermia, abnormal body movement, and cardiac problem and can communicate to the health persons through mobile devices using an android application.

Contact-less monitoring. Breakthrough technologies for contactless measurement of vital physiological monitors, that is, breathing, pulse, and arterial blood oxygenation, together with motion using optical camera sensors are on the horizons for opening a new contact-less and wireless era of neonatal care. These technologies allow monitoring of a health condition without attaching sensors to the body, which makes these very attractive across many healthcare applications, especially for neonatal monitoring, where use of on-body sensors might cause discomfort, skin irritations, and even cross-infections.

Still in the infancy stage, the technology promises to provide reliable and representative interpretation of the acquired vital signs. Robustness and full automatization of the measurements are among the main current research focus.

Advances in ventilation. Technological advances in neonatal ventilation made in recent years, have enabled clinicians to effectively control tidal volume delivered to neonates. Volume Guarantee (VG) in the NICU, a volume-targeted mode of ventilation automatically adjusts the inspiratory pressure to achieve a set tidal volume according to changes in lung compliance or resistance, or the patient's respiratory drive. VG ventilation in the NICU has led to more stable tidal volumes, with a lower incidence of hypocarbia and excessively large tidal volumes. When combined with other lung-protective strategies aimed at optimizing lung volume and ensuring even distribution of tidal volume, VG appears to offer a significant impact on minimizing lung injury induced by neonatal ventilation.

Advances in MRI. Researchers at the University of Sheffield, England,have developedkeg-sized MRI equipment. Whereas conventional MRIs have an opening of approximately 70 cm to fit the human body, the diameter for this mini-MRI is only half as wide, just larger than that of a basketball. Instead of transferring the baby between units, the smaller machine enables researchers to obtain clear images of the newborn directly in the neonatal wards. Within 20 minutes of placing the baby inside the machine, clinicians can capture a series of images that show not only the structure but also various processes, such as blood flow and the movement of biochemicals, inside the neonatal brain, a feat that would have been impossible before the advent of this prototype.

Way Forward

Neonatal care has come a long way in the last few years with gradual improvements in technology. Advances in remote monitoring and telecommunication hold a brighter future for the neonatal equipment industry, promising improved neonatal care. An increase in the clinical understanding of gestational development, technology advances, and the NICU care environment in the past few decades resulted in significant improvements in the quality of care and improved neonatal ventilation techniques, including the introduction of volume-targeted modalities of conventional ventilation. Moreover, the advancements in ultrasound and MRI fetal imaging have enabled scientists with better diagnostics to detect fetal abnormalities.

Forthcoming technologies combined with computer intelligence and the wireless networks are the on the verge of entering the neonatal care industry, as the leading manufacturers, in collaboration with clinical partners, work on the real-life applicability of these systems. The industry has a long way to go with the researchers and manufacturers coming up with the latest innovations and cutting-edge technologies. These impending researches to make NICUs a wireless and painless experience for the neonates hold the potential to reshape the neonatal equipment industry.

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