New tech for newborn intensive care units

05 March 2019

Interview with

Amy Paller & John Rogers, Northwestern University in Chicago

NEW-BABY

Yawning baby wrapped in cloth

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Premature babies, meaning those born before 37 weeks, can have a lot of medical problems. They’re more prone to infection, and immature lungs mean that they often need help breathing. Because these babies are so vulnerable, it’s crucial to monitor vital signs like blood pressure and temperature, to be aware of complications that might be brewing. Currently this means a mass of wires and electrodes, which can cause damage to very thin skin. Katie Haylor spoke with Amy Paller, a paediatrician at Northwestern University...

Amy - As you can imagine it tethers the baby to the bed, it limits the movement but it also limits the access to the baby for health care personnel. Most important though, it decreases the access for the parent. And right now, skin-to-skin contact has truly been shown to be important for the health of these premature babies. Repeated studies have shown that it decreases the risk of infections. It increases the ability to gain weight. It decreases mortality and it's been shown as well to decrease lung disease and liver disease. And these wires get in the way of being able to do that well.

Izzie - The solution? This week an interdisciplinary team of scientists at Northwestern University in Chicago have published a paper on skin-like, soft, flexible electronic sensors, that require minimal adhesives, and take up minimal space on the baby. One on the chest, another on the foot. These sensors are able to all the information of current wired monitoring methods, but crucially, this new system is wireless. John Rogers is the senior engineer on the study.

John - The power is delivered wirelessly through a loop antenna that we place underneath a mattress in the isolette. This power enables the sensors to operate and to capture heart activity, respiration rate, body temperature, and blood oxygenation. Time synchronised data from each of these devices is transmitted wirelessly back to the same loop antenna which itself is connected to reader electronics, also in the base of the isolette. A bluetooth radio interface to that reader electronics then transmits the data from the reader to a tablet computer with a graphical user interface that displays the data in a format that's familiar to the nurses.

Katie - Now have you ever paid for something in a shop simply by touching your phone to a reader? Well that kind of tech is how the baby's data gets from the sensors on its skin to the device under their little mattress in the intensive care unit. And then Bluetooth, just like you can connect to via your smartphone gets this data from the mattress to the nurse's station. And it turns out that these new sensors can match the capability of the current wired methods. And then some. Back to John.

John - Our skin-like devices also provide additional data streams such as continuous measurements of temperature at two locations across the baby's body; the chest and the foot. And this differential temperature can be an important parameter that nurses can track and in addition we actually capture the transit times for pulses of blood to move from the heart to the foot. And this transit time can be used as a surrogate for blood pressure, thereby allowing continuous tracking of this important parameter without the need for a cuff.

Katie - And this is important because blood pressure cuffs can cause bruising in such tiny babies and only give a reading at one time point, and other methods to measure blood pressure can be invasive. So just how impactful is the wireless nature of the senses. Back to paediatrician Amy Paller.

Amy - Parents can pick up the baby without being encumbered. Health care personnel can have better access, but it also means that the baby can get wet and these can stay on. Imaging through chest x-rays and MRIs does not get obscured or interfered with. In general there can be just better access and better care of the baby. We've now been able to utilise this device side-by-side with the wired monitoring in almost 90 babies. The accuracy is tremendous and we've seen absolutely no adverse effects.

Katie - Sounds very promising. And looking ahead, could this technology have applications beyond the neonatal intensive care unit?

Amy - We're already extending this technology beyond babies. It's now in our paediatric intensive care unit. It's going into our cardiac care unit. It's being extended to adults as well at at our hospital. The sky's the limit because we're expecting it soon to be deployed to outpatient settings. I think it's very important also to recognise the value of this wireless technology outside of developed countries and in fact the Gates Foundation and Save the Children have provided funding to deploy 20,000 of these devices in Zambia, Pakistan, and India. And we're hoping that these devices will really help with the morbidity and mortality rates that are seen right now in those countries.

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