MedTech center finds secrets in a heartbeat

New technologies will predict infection, prevent brain disorders

What do you get when you gather pediatricians and engineers and put them together in a room?

Solutions to children’s medical problems, according to Dr. Harel Rosen, director of the Medical Technology Center for Infants and Children (MedTech Center) at The Children’s Hospital at Saint Peter’s University Hospital in New Brunswick.

"The fruits of research can take decades to trickle down from adults to children," said Dr. Rosen, a neonatologist who has taken that model and turned it on its head. "We can no longer afford to wait for technology to come to us. We have to be the spark that launches the quest for new technology."

The MedTech Center is a partnership between neonatologists and pediatricians at Saint Peter’s and engineers and scientists at Drexel University in Philadelphia and the New Jersey Institute of Technology.

Together, the group targets infants’ medical needs, designs solutions and builds the technology to fill them.

NIRS versus LED

Take, for example, near-infrared spectroscopy (NIRS), a light technology that, up until now, used lasers to measure oxygen content in soft tissue deep within the body. This technology has not gained popularity for use in children because, as Dr. Rosen explained, "The safety of lasers and their effects on the brain are not well known."

Yet, measuring oxygen levels in deep tissue is important to diagnose and prevent certain problems — damage to a newborn’s brain, for instance. So the MedTech Center has come up with a solution of its own.

"We’ve taken NIRS and replaced the laser with light-emitting diodes — every-day LED technology," Dr. Rosen said. The tiny orange light on your computer monitor that turns green when you boot up is an example of an LED, he explained. LEDs can "see" through thick and deep tissues, but presents no hazard or discomfort to the child.

"While NIRS has been around for decades, we’re the first to adapt the technology for infants," Dr. Rosen said.

The MedTech Center has been using NIRS in Saint Peter’s Neonatal Intensive Care Unit with very promising preliminary results.

Secrets of the heart

Another MedTech project currently under way is research in heart-rate-variability analysis.

"There are secret messages within the variation of heartbeats that look normal to the naked eye. But if you look closely, these variations tell you a different story," Dr. Rosen said. "There are quantifiable physiological data in those variations and great potential in what that information can be used for."

Variations found in an infant’s beating heart can tell doctors if a baby is developing an infection —24 to 48 hours before it actually happens. Steps can then be taken to help prevent the infection.

"There are many other things HRVA can tell us," Dr. Rosen said. "We have the technology, but we need to conduct more research. HRVA is a very powerful tool."

Plans are being made to wire the neonatal intensive care unit with heart-rate-variability analysis monitors so that every baby’s heartbeat can be "read" at all times. Heart-rate-variability analysis is noninvasive and poses no harm to newborns.

Shedding blue light on jaundice

Among the founding members of the MedTech Center is Dr. Arye Rosen, a biomedical engineer with Drexel University. Dr. Rosen is working with his son, Dr. Harel Rosen, to develop a high-intensity blue-light treatment for jaundice.

Jaundice occurs in newborns when excess bilirubin, which is yellowish-orange in color, accumulates in the baby’s blood, causing the skin to look yellow. Bilirubin is a byproduct of normal red-blood-cell break-down and is filtered from the body through the liver. It takes a newborn’s liver a couple of days to manage this process, however, and in the meantime bilirubin can accumulate. Today, a jaundiced baby must stay in or come back to the hospital, where he or she lies under blue lights for several days until the liver can handle its job.

The Rosen team is creating a garment with blue LEDs imbedded in the fabric. The treatment, therefore, is intensified and can correct the problem more quickly, not to mention more conveniently.

"The baby will not need to be admitted to the hospital, and the family can go about their normal activities," Dr. Harel Rosen explained. "This garment could really change how we approach jaundice. It is solid technology and safe. Safety is our number one concern."

Room for new ideas

"The MedTech Center has brought problems and solutions together in one room," Dr. Harel Rosen said. "We have clinicians who know what children need and engineers with solutions. If we never sat down together, we would never discover the possibilities for cooperation. The MedTech Center has created a critical mass of interactions and ideas that will generate a constant flow of new treatments and medical innovations for infants and children."

And, by the way, technologies developed in the Med Tech Center for Infants and Children will flow upwards and will some day help adults.

Federal funds further R&D

The Medical Technology Center for Infants and Children (MedTech Center) at The Children’s Hospital at Saint Peter’s University Hospital will be supported by corporate and private donations as well as government grants.

The center recently was awarded a $200,000 grant from the U.S. Department of Health and Human Services. The money will fund technologies currently being developed in Saint Peter’s Neonatal Intensive Care Unit.

"We approached our federal representatives, who recognized that our research is unique and that we need to speed up the development of pediatric technologies," said Dr. Harel Rosen. "We are very thankful to Representative Jim Saxton, Representative Frank Pallone, Senator Jon Corzine and Senator Frank Lautenberg. Their support in helping us obtain this appropriation enables us to move our current projects forward." A portion of the federal grant is being designated for the installation of a heart-rate-variability monitoring system in Saint Peter’s neonatal intensive-care unit.

The monitors will help neonatologists predict when an infant is about to develop an infection —invaluable information that will help protect these fragile new lives. Other projects also will be funded through this grant. "All funding goes into the work and operation of the MedTech Center," Dr. Rosen said.

— Submitted by The Children’s Hospital at St. Peter’s University Hospital

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