Scientists at UCLA www.ucla.edu have developed a simple treatment for a common breathing problem among premature infants. Each year about 150,000 babies are born after only 23 to 24 weeks of gestation which puts them at risk for apnea of prematurity. This is a condition where breathing stops often for several seconds accompanied by severe falls in oxygenation.
This condition occurs because the infant’s system may not be fully formed and as a result, the respiratory system ignores or can’t use the body’s signals to breathe. Compounding the danger, premature newborns’ lungs are not fully developed and therefore do not have much oxygen in reserve.
When breathing stops in periods of apnea, the level of oxygen in the body goes down, and the heart rate can drop. That combination can damage the lungs and eyes, injure the nerves to the heart, affect the hormonal system, or injure the brain.
While most premature babies eventually grow out of their breathing problems, it can take weeks to months before their respiratory systems develop sufficiently to allow them to breathe on their own at all times.
Hospitals use a range of approaches to minimize the duration or premature babies breathing pauses by placing them on their stomach, forcing air into the lungs with a face mask, and giving the babies caffeine to stimulate the brain. However, this approach is not perfect as it carries other risks.
Dr. Ronald Harper, Professor of Neurobiology at the David Geffen School of Medicine at UCLA http://medschool.ucla.edu discovered along with Dr. Kalpashri Kesavan, Neonatologist at Mattel Children’s Hospital UCLA www.uclahealth.org/mattel how a baby’s breathing could be supported if the brain was told the baby’s limbs were moving.
Dr. Harper’s lab which focuses on brain mechanisms that drive breathing during sleep developed the device to help with breathing problems. The device is a pager-sized box with wires that connect to small disks which are placed on the skin over the joints of the feet and hands. Once the battery-powered machine is turned on, the disks gently vibrate triggering nerve fibers to alert the brain that the limb is moving.
The researchers tested the device on 15 premature infants who were born after 23 to 34 weeks of gestation and were experiencing breathing pauses and low oxygen. The disks were placed on one hand and one foot, with the device turned on for six hours at a time, followed by six hours off, for a total of 24 hours.
The scientists found that when the device was on, the number of incidents where the babies’ oxygen levels were low was reduced by 33 percent and the number of breathing pauses were 40 percent lower than when it was off.
According to Dr. Kesavan, “Long term use of the device could decrease breathing pauses, maintain normal oxygen levels, stabilize the cardiovascular system, and help improve neurodevelopmental outcomes in preterm infants.” Dr. Harper is also testing the device on adolescents who suffer breathing problems due to spinal cord injuries and adults with sleep disordered breathing including obstructive sleep apnea.
The research was supported by grants from the UCLA Children’s Discovery and Innovation Institute. The University of California has applied for a patent for the device and is discussing commercializing the device with several companies.
The study was published online in the Journal of PLOS One http://journals.plos.org/Plosone