Kalipay Acevedo wasn’t due to have her baby for another month, when one sleepy Sunday morning recently she felt her stomach drop. No pain. No contractions. She was just gushing blood. Her husband, Miguel, called the ambulance to their Tampa home. Kalipay passed out on the way to the hospital. She had had a placental abruption, a condition in which the placenta detaches prematurely from the uterus. The resulting loss of oxygen and glucose to the baby’s brain caused a condition called hypoxic-ischemic encephalopathy. Doctors quickly delivered baby Sianna Marie Acevedo by Caesarean section. But she wasn’t breathing. In fact, she didn’t breathe for about 14 minutes. Her little heart pumped at just 30 beats a minute — much slower than the 100 to 160 beats a minute considered normal for newborns. She was pale and wasn’t moving.
“I broke down. I thought I had lost my child,” Miguel Acevedo says.
Within the hour, Sianna was on her way by helicopter to Shands at UF. There, neonatologist Michael Weiss, M.D., and his team in the neonatal intensive care unit have been using a body cooling technique to try to stave off damage to the brains of babies like Sianna. Weiss and his team started quickly to carry out the procedure, called systemic hypothermia. They placed the baby on a pad attached to a temperature control machine, cooling her body to about 7 degrees Fahrenheit lower than normal body temperature for 72 hours. EEG electrodes attached to her head allowed monitoring of her brain activity patterns that could give clues about how she will fare after the treatment. A cerebral saturation monitor, connected to the lead on the baby’s forehead, gave Weiss an idea of blood flow to the brain.
UF is one of the few institutions to use this monitor and one of the few in the state to offer the cooling procedure. Before 2004, when babies with diagnoses like Sianna’s came in, all doctors and nurses could offer was “supportive care” — such as monitoring the baby’s blood pressure and glucose levels, checking that the kidneys are working properly and stanching any bleeding. “There was nothing we did that was geared at minimizing the amount of injury the brain had,” Weiss says. Now, even though the cooling procedure is available, it is not universally used. Weiss is trying to change that by teaching colleagues at other hospitals about the technique. He and other health professionals and researchers at UF and Shands continuously seek out new ways to help patients, often when there are no alternatives. In so doing they help to make UF and Shands a fertile ground for development and use of new medical technologies, whether it’s using brain-saving cooling protocols, developing new vaccines or exploring new applications for robot-assisted surgery.
UF neonatologist Dr. Michael Weiss used a new cooling technique on newborn Sianna Acevedo, who was deprived of oxygen during birth, to help stave off brain damage. The white pad underneath her is used to regulate her temperature. “I think UF has a lot of highly intelligent investigators who are working to get new therapies to patients,” says Johannes Vieweg, M.D., chair of the department of urology, which has a division of robotics and minimally invasive surgery. “We want to be known as a hub for innovative therapies.” New initiatives such as UF’s Clinical and Translational Science Institute and the Florida Innovation Hub serve to foster a culture of technology and invention and speed new discoveries to patients. Weiss has treated 10 babies with the cooling procedure in the two years since he started offering it. Now, he is trying to help even more babies around the state. He is applying for a grant from the CTSI to develop the Florida Neurologic Network, a collaboration among the UF and Shands hospital system and other academic and private hospitals in North Central Florida that aims to improve the hypothermia technique, instruct other doctors on its use and make it more widely available.
“To me that’s really exciting to be able to get it out to more people,” says Chris Batich, Ph.D., associate director of the CTSI, who works to bring physicians into collaborations with engineers, scientists and other experts who can turn research ideas into technologies that can help even the littlest of patients, like Sianna, and bring them into widespread use. Whether it’s in caring for newborns or helping people struggling with infertility, new technology at UF is giving people hope.