Low-cost device averts baby brain damage

JOHNS HOPKINS (US) — A new $40 device could protect the brains of oxygen-deprived babies born where doctors can’t afford the $12,000 units used in advanced hospitals.

Extended cooling prevents brain injuries and disorders such as cerebral palsy in babies starved for oxygen before birth. But such treatment may not be readily available in poor countries where sophisticated medical care is scarce.

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The new low-tech device, invented by biomedical engineering undergraduates, aims to lower a newborn’s temperature by about six degrees Fahrenheit for three days, a treatment that has been shown to protect the child from brain damage if administered shortly after oxygen loss has occurred.

In a recent issue of the journal Medical Devices: Evidence and Research, the student inventors and their medical advisors reported successful animal testing of the Cooling Cure prototype.

The device consists of a clay pot, a plastic-lined burlap basket, sand, instant ice-pack powder, temperature sensors, a microprocessor, and two AAA batteries. To activate it, just add water.

“The students came up with a neat device that’s easy for non-medical people to use. It’s inexpensive and user-friendly,” says Michael V. Johnston, a Johns Hopkins School of Medicine pediatric neurology professor who advised the undergraduate team.

The device is intended to combat a serious health problem called hypoxic ischemic encephalopathy, triggered by oxygen deficiency in the brain. Globally, more than half of newborns with a severe form of this condition die, and many survivors are diagnosed with cerebral palsy or other brain disorders.

Common causes are knotting of the umbilical cord or a problem with the mother’s placenta during a difficult birth. In developing regions, untrained delivery, anemia and malnutrition during pregnancy can also contribute to oxygen deprivation.

Johnston is chief medical officer and executive vice president of the Kennedy Krieger Institute, a center in Baltimore that helps children and adolescents with disorders of the brain, spinal cord, and musculoskeletal systems.

For 25 years, he has studied ways to protect newborn brains, including the use of hospital cooling units—costing up to $12,000—that keep brain cells from dying after an oxygen deficiency.

Several years ago, while visiting Egypt, Johnston learned that local doctors were using window fans or chilled water bottles in an inadequate effort to treat oxygen-deprived babies.

Back in Baltimore, Johnston and Ryan Lee, a pediatric neurologist and postdoctoral fellow at Kennedy Krieger, discussed the problem with Robert Allen, who suggested that Johnston and Lee present the baby-cooling dilemma to students in the school’s Center for Bioengineering Innovation and Design.

Cold-pack method

A team of undergraduates accepted the challenge in 2011. With an eye toward simplicity and low cost, the students put together their clay pot and plastic-lined inner basket, separated by a layer of sand and urea-based powder. This powder is the type used in instant cold-packs.

To activate the unit, water is added to the sand and powder, causing a chemical reaction that draws heat away from the inner basket, which cradles the child. (The chemical would not come into direct contact with the newborn.)

The unit’s batteries power a microprocessor and sensors that track the child’s internal and skin temperatures. Small lights flash red if the baby is too hot, green if the temperature is correct, and blue if the child is too cold. A nurse or a family member can add water to the sand to increase cooling. If the child is too cool, the caregiver can lift the child away from the chilling surface until the proper temperature is restored.

The students’ prototype is designed for a full-term newborn up to 9 pounds and 18 inches. In August, two of the inventors visited medical centers in India through a group called Medical and Educational Perspectives. The group has also offered financial support to advance the Cooling Cure project.

In recent months, three of the inventors—John J. Kim, Nathan Buchbinder, and Simon Ammanual—have moved the project forward.

Working with Johns Hopkins Technology Transfer, the students and their faculty advisors have obtained a provisional patent. They now hope to link up with an international medical aid group and begin human clinical trials in a developing region.

Source: Johns Hopkins University