Listen to the UVA Today Radio Show report on this story by Jane Ford:
September 2, 2011 — An innovative monitoring system for premature infants developed at the University of Virginia Health System is saving lives by spotting early signs of infection and other illnesses.
Ten years ago, U.Va. cardiologist Dr. J. Randall Moorman 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," Moorman said. "It stands to reason that early diagnosis and an early start on treatment should improve the outcome for 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 3 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 of 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," said Dr. Karen Fairchild, a U.Va. neonatologist who relies on the HeRO monitor in the neonatal intensive car unit, or NICU. "It's a way we can tell among the 45 babies in the NICU which ones are starting to get sick and need extra attention. 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 said.
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 one infant's life for every 48 who were monitored.
The patented monitoring technology was developed at the U.Va. Health System. The rights are licensed by the University of Virginia Patent Foundation to Medical Predictive Science Corporation in Charlottesville. 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.