INSIDE RADY CHILDREN’S
TECHNOLOGY AI Brings
Preventive Care Within Reach for Critical Pediatric Patients
Clinicians and researchers in pediatric intensive care are working with AI- enabled monitoring technologies to avert crises before they begin. Rohit Rao, MD, Medical Director of the Cardiothoracic Intensive Care Unit (CTICU) at Rady’s Children’s, knows the value of quick reactions in a crisis. But better still, and the preferable model in any health care setting, is to anticipate that crisis and resolve it before the patient comes to any harm. “In critical care, we show up at the bedside, save a life, stabilize the patient, and then help with recovery,” the pediatric cardiologist and cardiac intensivist says. “That’s great, but I would rather be able to correct the problem so early that the child never reaches a crisis in the first place.” Dr. Rao likens the intensivist’s current role as being akin to a firefighter, someone skilled at reacting to emergencies, but unable to prevent them. He’d rather be like a smoke alarm, he says, using an early-warning system to change a dangerous clinical trajectory at the earliest opportunity. Dr. Rao and his colleagues are making progress toward this vision of preventive care with the CTICU’s addition of Sickbay, an FDA-cleared, artificial intelligence-enabled
real-time remote patient monitoring platform. In 2022, thanks to a $1 million grant from the Conrad Prebys Foundation, Rady Children’s became the first hospital in California to use the technology, which allows doctors to monitor blood circulation and how well the heart is working at any CTICU bed. AI IN ACTION “The platform shows us vital parameters in a meaningful, actionable format, from 12-hour trends all the way down to one-minute trends, with all data stored in the cloud,” Dr. Rao says. “When an event happens, we can go back and look at the vitals to see what triggered the patient to decompensate. That’s important because many of these events do not trigger the monitor alarms.” That was the case with a two-day-old infant in the CTICU who had been diagnosed with Ebstein’s anomaly, a rare congenital heart defect. A nurse practitioner looked at the AI platform and saw the heart rate was variable at 120 and suddenly increased to 160 without variability. “That’s still within normal range for an infant, so no alarms were triggered at the bedside,” Dr. Rao says. But when he arrived, the newborn patient was in atrial flutter and had low cardiac output. If the new technology had not detected the sudden change in heart rate trends before clinical symptoms
28 HEALTHY KIDS MAGAZINE WINTER 2024
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