Pediatric medical innovations

At the very first strategic planning session between Children’s Healthcare of Atlanta and Georgia Tech, Dr. George Raschbaum described a problem that needed solving.

The Children’s pediatric surgeon was frustrated with his surgical tools. He performs more than 50 operations each year on infants that have a condition called pyloric stenosis. Food can’t pass through their digestive tracts because an olive-shaped muscular valve between the small intestine and stomach is thickened, resulting in obstruction of the stomach.

The tool that Raschbaum uses to grab organ tissue during surgery wasn’t designed for grasping the pylorus, but it’s the best one he has to work with. Raschbaum would often spend up to 25 minutes of a 30-minute surgery struggling to grab and stabilize the pylorus.

Raschbaum challenged the Georgia Tech engineers to solve this problem. Leanne West, a Georgia Tech engineer, approached him and suggested a potential solution. West spread the word about her idea, and a team of engineers began working to solve Raschbaum’s problem.

Now just 16 months into the partnership, a final prototype of Raschbaum’s Grasper, as the new device is called, is expected soon. The Grasper has a new ergonomic handle and redesigned tips. The device is still under development, but the team hopes it will one day reduce surgery times, lower hospital costs, and help surgeons be more efficient.

The time from concept to prototype of the Grasper has been remarkably fast, but it’s exactly what Children’s and Georgia Tech envisioned when they announced their partnership.
 

Collaborative R&D

“At Georgia Tech we’re focused on doing research that has a very real impact on society,” says Steve Cross, Georgia Tech’s executive vice president for research. “We’re proud to be developing technologies doctors can use to save the lives of children. It’s research that really makes a difference.”

West’s job, as the newly appointed chief engineer for pediatric technologies, is solving real world problems for clinicians by leveraging the expertise at Georgia Tech. Through her many roles, West is perfectly situated to pull together cross-functional, campus-wide teams.

“I’ve always gravitated toward projects that translate into the real world, and solve a real problem,” West states. “With this partnership, we are doing just that and in the process helping kids through innovative technology. That is what makes my new role so exciting.”

The partnership between Children’s Healthcare of Atlanta and Georgia Tech was boosted by a $20 million joint investment in June 2012 to bring technologies from concept to reality. The collaboration involves existing Children’s research centers, the Department of Pediatrics at nearby Emory University, and faculty and researchers from academic and research units throughout Georgia Tech.

“This collaboration brings together leading technology and leading pediatrics to change the lives of kids,” says Donna Hyland, Children’s president and CEO. “At Children’s, our mission is to make kids better today and healthier tomorrow. We are able to accomplish so much more through a strong partnership with Georgia Tech. The joint investment of expertise and resources makes it clear just how committed these organizations are to pediatric research, and it provides an extraordinary opportunity for others to join us.”

A big problem for children’s physicians is that so many medical devices were designed for adults. The market for children’s medical devices is so small that companies shy away from tailoring technologies to children. That’s why no medical device manufacturers have solved Raschbaum’s problem, and why the pediatric partnership between Children’s and Georgia Tech is so important.

Even before the partnership, these institutions had developed a chemistry that led to collaborating on several dozen pediatric research projects since 2007. The partnership has been led by the Georgia Tech-Children’s Healthcare of Atlanta Faculty Council, co-chaired by Gang Bao, of the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University; Robert Guldberg, of the George W. Woodruff School of Mechanical Engineering; and Beth Mynatt, executive director of Georgia Tech’s Institute for People and Technology.

To take the collaboration to the next level, West will help lead Georgia Tech’s side of the partnership along with Sherry Farrugia, who last year was tapped as the director of the partnership. Just as West will serve as a bridge between engineers and physicians, Farrugia is the bridge between the business and strategic operations side of the partnership.

“The Children’s and Georgia Tech partnership is about acting on a strategic plan to improve the lives of children through the use of technology,” Farrugia states. “Raschbaum’s Grasper is only one example of how a problem and potential solution were identified because of the partnership, but it is a blueprint for how clinicians and engineers will work together to solve problems.”

West has overseen the entire Grasper project from concept to prototype. The technology was designed at Georgia Tech, and now a prototype is being manufactured at the Global Center for Medical Innovation (GCMI), which is also guiding the Grasper through the U.S. Food and Drug Administration’s (FDA) approval process.

“With the ability to manufacture devices on campus at GCMI, I think over time there will be even more opportunities to shepherd an idea from concept to prototype,” West says.
 

Big ideas, challenges

One of the partnership’s strategic goals is to quickly solve problems that frustrate clinicians through the Quick Wins program. Projects funded through Quick Wins will focus on big ideas and grand challenges, such as personalized health, pediatric nanotechnology, and pediatric device innovation, and be in the hands of clinicians within 18 months. Two Quick Wins projects currently underway are in collaboration with the Marcus Autism Center. One focuses on telemedicine, and the other project focuses on eating disorders in children.

The partnership has also created the nation’s first Center for Pediatric Nanomedicine (CPN), led by Gang Bao, Robert A. Milton Chair of Biomedical Engineering at Georgia Tech. In addition to CPN, Georgia Tech hosts the Center for Pediatric Innovation (CPI), co-led by Robert Guldberg, Parker H. Petit Director’s Chair in Bioengineering and Bioscience at Georgia Tech, and Kevin Maher, associate professor of pediatrics at Emory and a pediatric cardiologist at Children’s. CPI supports research projects that focus on the development of new medical devices, therapeutics, and regenerative medicine strategies for improving pediatric healthcare.

In contrast to Quick Wins, pediatric nanotechology is historically considered a long-term venture, but it might have led to the partnership’s biggest success story so far.

When a solider at war is suffering from major trauma, or when a child is critically ill in the hospital, they are hooked up to an extracorporeal membrane oxygenation (ECMO) machine.

ECMO machines were designed for adults, but are used to keep children alive. When attached to the ECMO circuit, the venous blood is removed from the body and then pumped back in the arteries as oxygenated blood under pressure, performing the role of both the heart and lungs. The most common problem for patients on ECMO is the risk of clot formation. These clots can be severe, causing strokes and even death despite aggressive anticoagulation medicines.

To figure out a way to reduce the risk of clotting, Maher invited Georgia Tech engineers into the hospital’s Cardiac Intensive Care Unit.

“Because the relationship between Children’s and Georgia Tech exists, I can pick up a phone, talk to engineers, and actually bring them into the hospital to see the clinical problems that we’re dealing with,” Maher says. “That is one of the biggest advantages of the collaboration. It’s really very easy to do.”

With support from the Center for Pediatric Nanomedicine, the engineers evaluated the ECMO circuits, and then came up with a 12-month plan to bring the circuits to Georgia Tech after use by a child. The engineers, led by David Ku, a mechanical engineering professor at Georgia Tech, took apart the ECMO circuits to determine where clots were forming and what types of clots were present. The most prominent areas of clot formation were located at connecting joints.

The physicians and engineers then designed a nanomaterial coating for the inside of the tubes that minimizes the development of blood clots. These nanoparticle-based, non-thrombotic coatings for vascular devices such as the ECMO machine were based on a technology developed by Andrew Lyon, a professor in Georgia Tech’s School of Chemistry and Biochemistry.

“Without the three of us working together we couldn’t get anywhere,” said Ku, a Regents’ Professor of Mechanical Engineering and the Lawrence P. Huang Chair Professor of Engineering Entrepreneurship. “The partnership brings the clinicians in touch with the engineers. We weren’t talking to each other about this project at all before.”

The ECMO technology continues to be developed and tested, but is on track to meet the 18-month goal.

“If there was not a partnership, there would have been no way to have engineers to come and figure out what the problem is, much less be able to develop the solution to it,” Maher states.

This type of material coating could also apply to several types of technology used in pediatric cardiology, including cardiac pumps and indwelling catheters. After developing the technology for children, the group hopes to seek Department of Defense support for further work.

“Our hope is to continue to strengthen the relationship between Georgia Tech and Children’s Healthcare of Atlanta and develop solutions to better serve our kids,” West says. “The partnership has already resulted in several ideas. By working together, things are starting to happen. That’s really exciting.”

Georgia Tech
www.ipat.gatech.edu

About the author: Brett Israel is a communications officer with Georgia Tech and can be reached at brett.israel@comm.gatech.edu or 404.385.1933.