A baby is born, but she hasn’t gotten enough oxygen and blood to her brain. It’s a serious complication known as hypoxic ischemic encephalopathy, which requires immediate medical attention.
The standard of care is to cool the baby’s body temperature to 33.5 degrees Celsius (92.3 Fahrenheit) within six hours, which generally requires a Level III or higher neonatal intensive care unit (NICU). Many hospitals do not have the equipment or expertise to cool the baby in the required timeframe so they request a transport by the Johns Hopkins All Children’s LifeLine critical care transport team, which begins the cooling process en route by ambulance, helicopter or fixed-wing aircraft using a device called Tecotherm NEO.
Tecotherm illustrates how education, research and philanthropy come together to improve patient care.
Johns Hopkins All Children’s began passive cooling during transport in 2015, but only 17 percent of patients arrived in the NICU within the therapeutic temperature range. Transport nurse Christine Muller, APRN, reviewed the literature and evaluated the data on passive and active cooling techniques for a paper she published while earning a University of South Florida master’s degree. The paper, “Neonatal Transport during Therapeutic Treatment,” demonstrates that active cooling during transport improves outcomes. A group of transport nurses, respiratory therapists and physicians then formed to consider options for a device that would actively cool patients in transport.
The first option was a heavy and cumbersome unit not designed for transport, but in 2014, the Food and Drug Administration approved Tecotherm, a small, portable active-cooling device that worked nicely in transport.
Former Johns Hopkins All Children’s Foundation Guild chair Judy Keyak answered the call with a multi-year gift pledge to support the purchase, and the transport team began using Tecotherm in 2016. By January 2017, 86 percent of babies transported with the device arrived at the NICU in the therapeutic temperature range. The LifeLine team now transports about a dozen infants a year using Tecotherm with similar success.
This story first appeared in For the Kids magazine, a publication of the Johns Hopkins All Children’s Foundation.