Babies born prematurely sometimes fight for their lives from day one. Their organs may not be fully developed, and they commonly have trouble breathing, feeding and digesting. In the U.S., 8 percent to 10 percent of babies arrive earlier than planned each year.
"You are talking about babies at the verge of viability," said Dr. Charles Palmer, professor of Pediatrics at the Penn State Children's Hospital. "The challenges to keep them alive are quite severe."
Palmer is part of a team trying to improve the the preemies' chances. He heads up the Pediatric Innovation Program at Penn State, which he describes as a loosely bound stew of talented people working together to develop and test the latest in neonatal technology.
The central theme of the research is to create an external way in which a baby's brain is able to develop as it would have within the womb. "We are trying to provide an optimal environment so that the baby can be allowed to develop without any adverse event," Palmer said. And while Penn State's program is not yet as robust as he would like it to be, the development of a number of devices is already underway and aimed at addressing everything from breathing to feeding difficulties.
One of the most common problems preemies have is difficulty breathing. When the baby is born ahead of schedule, the rib cage is soft, Palmer said. This can make the chest cavity collapse in some cases.
"When I saw the chest wall buckling in, I realized we needed something to stabilize the chest wall (in these cases)," he said. As a remedy, Palmer developed the Hug 'n' Snug Neonatal Chest Splint. The non-invasive device wraps around the baby to provide external stabilization to the chest and allows the baby to breathe easier.
Though the Hug 'n' Snug is still in clinical trials, Palmer said he is excited about the possible use of this device in developing nations. It is a low-tech device that he hopes can be used in places where ventilators are unaffordable.
Another innovation still in development was discovered right under the baby's nose and aids in keeping the child clear of infection. The care babies need to survive is often given through the use of a feeding tube or respirator. Although much of the equipment used to help babies may appear high-tech, these tubes are usually taped to the babies face using plain old adhesive tape.
After a few hours or days in an incubator, however, the tape ends up warm and covered in saliva -- the perfect breeding ground for bacteria. As babies born prematurely are especially susceptible to infection, it is important to keep these area as sterile as possible.
Palmer noticed it, and a new idea was born. He worked to develop the Naso Oral Respiratory Interface System, or NORI. The device has two arms that rest on the cheeks of the baby and provide a more stable, hygienic way for the tubes to enter the mouth. This device keeps the mouth and skin clear of tape and helps prevent a tube from coming out at the wrong time, Palmer said.
Another challenge with newborns -- as parents know -- is their inability to express what is bothering them. To remedy this, doctors are working on new ways of diagnosing minor irritations before they become major ones.
One way is by analyzing the air coming off a baby's skin. Doctors are working to use a coral-like hydrogen sensor developed at Penn State to catch a fairly common problem in preemies called necrotizing enterocolitis. When this condition occurs, a preemie doing fairly well in the neonatal intensive care unit abruptly changes course. "Suddenly one day they will have blood in their stool," Palmer said.
The condition is thought to be linked to bacteria in the intestine which ferments carbohydrates and produces gas partly made of hydrogen. Doctors hope that the hydrogen sensors can provide an early warning sign for the condition and earlier treatment.
Palmer is a believer in the potential greatness of the Penn State program. There, clinicians explain to engineers what they need, and engineers develop the device.
New technology for newborns
Palmer and his staff aren't the only ones dreaming up new ways to help preemies. Other areas of technological innovation include:
• Cough monitoring devices: Devices that measure the frequency and intensity of coughs to determine the severity of a patient's symptoms.
• Devices for measuring cardiac output: Researchers are looking into non-invasive ways to measure cardiac output, a key factor in oxygen delivery. Most current methods of measurement are invasive and hard to perform.
• Lung inflation monitoring device: Premature babies often are faced with respiratory difficulties that can be fatal or lead to a chronic problem. Researchers at the Ritchie Centre for Baby Health Research are considering whether sound can be used to determine lung inflation.