UCSF Neuro-Intensive Care Nursery reaches milestone


Watching Nolan Hochleutner play in his oak shaded yard, you'd never imagine the wild swings that marked the first few days of his life. When we first met Nolan in 2008, he was still recovering from a life saving treatment at UCSF. It was a cutting edge therapy that began just hours after a traumatic delivery cut off oxygen to his brain.

"They basically said, 'We don't know what's going to happen to him, he's lost of a lot of oxygen and we have to take him to San Francisco,'" said Nelya Hochleutner, Nolan's mom.

Nolan was one of the first infants treated in UCSF's Neuro-Intensive Care Nursery at the Benioff Children's Hospital. Doctors used a special temperature controlled incubator, designed to deliberately induce hypothermia.

"Cooling the body temperature down, which is protective for the brain that has suffered a lack of oxygen," said David Rowitch, M.D. from UCSF.

Rowitch says the hypothermia technique has been so successful at protecting infants from brain damage, that his team has invested in technology to make the overall treatment process even more effective.

"Our model at UCSF is different than anywhere else in the world because we bring in a pediatric neurologist, and because we have continuous monitoring of the brain at every stage," said Rowitch.

A powerful electroencephologram can detect if an infant is having a seizure, even when there are no external symptoms. And a camera system gives neurophysiologists access to the readings around the clock.

UCSF Hannah Glass, M.D., says she can check the readings "in the neurophysiology lab, or at home at night, on a personal computer."

A few feet away, one newborn is being monitored with a second new device that looks at the brain in a different way.

"So this is a near infrared spectroscopy monitor. And what is allows us to do is to understand how well is brain is either getting oxygen delivered to it, or how well it's using oxygen," said UCSF Sonia Bonifacio, M.D.

In a nearby lab, neonatologist Fernando Gonzalez, M.D. is experimenting with growth factor, which is already used to raise the red blood cell count in infants. He said, "So we're studying how combining Erythropoetin with hypothermia can provide more long-term protection."

"I think we are entering a very exciting age in the care of neonates," said Rowitch.

Heading off conditions like cerebral palsy and giving newborns like Nolan, a chance to grow into a healthy, energetic children.

"He's just the most sparkly kid. That's the best way to describe him, sparkly," said Nelya.

A quick update -- doctors at UCSF treated their 200th cooling patient just last week. Beyond the hypothermia treatments, the Neuro-Intensive Care Nursery also provides life saving care for some of the smallest premature infants born in the Bay Area.

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