T O . B R E A T H E
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T O . B R E A T H E |
The following feature story appeared in the campus publication MOSAIC in January, 1996.
Forgetting to Breathe
A student discovers her vocation in neonatal intensive care.
In hospital neonatal intensive care units, premature babies sometimes simply stop breathing. "Their respiratory systems are usually underdeveloped. For some very premature babies this happens eight to 10 times a day and it can be fatal. It's a condition called apnea," said Amy Marcotte '96. "About 85 percent of babies who've had a gestation period under 28 weeks have it." Until September, when she began to work on a research team led by Dr. Leonard Eisenfeld at Hartford Hospital, Marcotte was an accomplished biomedical engineering student but knew little about apnea or the dramatic world of the neonatal intensive care. Now, as a result of her senior project, the Trinity senior is applying to a doctoral program that specializes in neonatal bioengineering.
"Premature babies can just forget to breathe. When there's a pause in a baby's breathing in the nursery, a nurse has to come by and stimulate the baby," Eisenfeld said. "If the nurse is already dealing with a sick baby, she or he has to stop, wash hands, and then deal with the apnea. After only 15 or 20 seconds trouble starts, so that time delay can be dangerous." "To revive the baby," Marcotte said, "a nurse just literally shakes it gently. But that often wakes up the infant and causes it discomfort," said Marcotte, who is from Feeding Hills, Mass. Eisenfeld's team is developing a device called a vibrotactile stimulator that can be activated by remote control or linked to a computerized breathing monitor which can trigger it automatically when a baby stops breathing. "We're trying to close the loop, to make the monitor a therapeutic instrument as well as diagnostic instrument," Eisenfeld said. "This is real hands-on experience and it has given me a new focus," Marcotte said. "Neonatality is fascinating, and I love being involved in actual clinical research." Marcotte's work in the hospital's pediatrics department forms the basis of her senior project in the engineering department.
She spent much of the fall designing and engineering the stimulator itself, which is an adapted version of a tactile device originally designed for the hearing-impaired. "The device vibrates to stimulate the baby's breathing. The trick is to do this without waking the baby or causing it discomfort or any risk," she said. "One of the issues we've had to solve is finding the best frequency for the device to vibrate at. It turns out that 250 Hertz is very effective, but 400 to 500 Hertz are not as effective."
Launching Clinical Studies.
This spring, Marcotte anticipates spending two or three afternoons a week participating in the clinical trials scheduled to test the device. "I'm looking forward to sitting by the crib and triggering the device when a baby has an apneic episode. The clinical studies will help define the apnea detection algorithms necessary for the computerized breathing monitor's software."
"Amy's very bright and eager," Eisenfeld said. "She's so interested in the subject and is able to bring together different groups of people to work on the project. She's a catalyst." Joseph Bronzino, Vernon Roosa Professor of Applied Science and a nationally-prominent biomedical engineer, suggested the project to Marcotte for her senior thesis. Steve Goodison, a student in Trinity's Individualized Degree Program, is also involved in the project and is working on other aspects of its development.
Marcotte's interests have long oscillated between medicine and engineering. "For a long time I planned to be a doctor, but I had a fabulous physics teacher in high school who led me to consider engineering," said Marcotte, who was named President's Fellow in engineering for 1995-96. Each year, each of Trinity's academic departments and programs nominates a senior to be its President's Fellow, based on outstanding achievement and evidence of wide-ranging intellectual curiosity.
As a result of her education at Trinity, Marcotte plans to combine both professions by earning an M.D. and a Ph.D. in neonatal bioengineering, with graduate school as the first step.
The liberal arts advantage.
"The other colleges that I applied to were engineering schools. In the end, I picked Trinity because the liberal arts dimension just offered me more options," she said. "It's been a great mix for me. The faculty at Trinity are really amazing and the lab facilities here are remarkable. I've had much more access to faculty and facilities than my friends at engineering schools. Most importantly, at Trinity, we don't have to compete with graduate students for the attention of the faculty. The faculty focus their attention on us."
- Andrew Walsh