Neuro-intensive care nursery opens at UCSF

November 13, 2008 9:54:26 AM PST
Some of the most fragile newborns and preemies in the Bay Area are now being treated with cutting edge technologies. We take you inside a newly created unit at UCSF's Children's Hospital.

"It was such a difficult time. I just wanted him to be okay, that's all I wanted," said Nolan's mom Nelya Hochleutner.

For Nelya and Mike Hochleutner's newborn son, being okay ultimately hinged on his brain's ability to recover from a traumatic lack of oxygen triggered when Nelya's uterus collapsed during delivery.

"All his vital signs started going down, so it was very quick and immediate. It was a total emergency," said Hochleutner.

Within hours, their son Nolan was rushed to a facility at UCSF Medical Center -- that's one of the first of its kind in the country. It's called the Neurodevelopmental Intensive Care Nursery or NICN.

Dr. David Rowitch helped develop the unit to specifically treat newborns with brain and neurological trauma.

"The idea is bring all the expertise to bear to help babies with these kinds of problems," said Dr. Rowitch.

To give Nolan's brain time to recover, doctors used a special cooling incubator designed to induce hypothermia. It slowly chilled his body temperature to just over 33 degrees.

"By doing that you affect metabolism of the brain, you change the cellular programming of brain cells so they don't die off after secondary injury and hopeful give them time to recover," said Dr. Yao Sun from UCSF Children's Hospital.

Using a doll, Clinical Director Dr. Sun demonstrated the sensors used to monitor brain activity over the next 72 hours. He says the treatments effect on infant brain recovery is only partially understood.

"It doesn't work for the most severely injured babies, many of whom are at risk for dying from injury. But for moderately injured babies, both human clinical trials have show there can be improvement," said Dr. Sun.

After three days, infants treated with hypothermia, like newborn Vaughn, are brought back to their normal temperature.

While his mother waits, doctors say it's often several weeks before they can gauge the treatment's effectiveness.

"He's physically probably going to be okay, they just didn't know neurologically what it would look like and we won't know till he's off everything and the do the MRI," said Vaughn's mom Tamar Eggers.

A mobile incubator invented at UCSF can safely roll even a tiny premature infant directly into the MRI, to give doctors a closer look at the brain's recovery.

Other specialized equipment is integrated together in the unit to treat multiple issues at once.

In the case of Nolan Hochleutner, he recovered and headed home with no immediate signs of impairment.

"The contraptions slowly started to come off him, less wires, so little by little they were unraveling a human baby, rather than this matrix baby," said Hochleutner.

Treatment is only one aspect of the NICN, the other is research. Many of the techniques used in neonatal neurology are still evolving, and doctors at UCSF are collecting data that could be the basis for future treatments.


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