04:13pm Sunday 24 September 2017

New monitor invented at UVA saving the lives of premature babies

J. Randall Moorman, MD

Ten years ago, J. Randall Moorman, MD, a UVA cardiologist, and his team made a critical observation.  They identified characteristic changes in the heart rate of babies with illness that appeared 12 or more hours before the infants showed any clinical signs. “We thought we could use this information to prevent these babies from becoming seriously ill,” says Moorman. “It stands to reason that early diagnosis and an early start on treatment should improve the outcome of the infant.”

He and his colleagues developed mathematical algorithms that analyzed the stream of data generated by the babies’ heart rate monitors, leading to the current Heart Rate Observation System, or HeRO monitor.  Using information already present at the bedside monitor, the algorithms determine the likelihood that an infant is developing illness, and present clinicians with the level of risk for approaching problems.

Premature infants – especially those weighing three pounds or less at birth – are especially vulnerable to sepsis, a deadly bacterial infection.  Despite the best efforts of nurses, nurse practitioners and physicians, up to half of these very low birth weight babies develop the disease, which accounts for half the deaths among infants who require intensive care for more than a week. In its early stages, sepsis has few distinguishing symptoms, and it can escape diagnosis until it is too late.

“It’s essentially an early warning system, especially for sepsis. It’s a way we can tell among the 45 babies in the NICU [Neonatal Intensive Care Unit] which ones are starting to get sick and need extra attention,” says Karen Fairchild, a neonatologist at UVA who relies on the HeRO monitor. “For example, this way we can treat sepsis early before the baby gets terribly sick.”

“The HeRO monitor picks up things you wouldn’t notice on the standard heart rate monitor,” she said, describing the early detection of sepsis as “extremely difficult.” “A lot of the symptoms of sepsis in the early stage are subtle, and they’re also nonspecific, meaning they’re things premature babies do all the time, even when they’re not septic,” she says.

The results of a multicenter study of the HeRO monitor co-sponsored by the National Institutes of Health and Medical Predictive Science Corporation are published in The Journal of Pediatrics.  In this study of 3,000 preterm infants, the HeRO monitor reduced mortality by more than 20 percent, saving 1 infant’s life for every 48 that were monitored.

The patented monitoring technology was developed at the University of Virginia Health System. The rights are licensed by the University of Virginia Health System Patent Foundation to Medical Predictive Science Corporation in Charlottesville, Va. Moorman has an equity share. The monitor, which is made by Medical Predictive Science Corporation has been cleared by the FDA and is being acquired by hospitals across the country.

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