40 Years of Saving Babies' Lives at UCSF Children's Hospital

September 15, 2000
News Office: Janet Basu (415) 502-4608

1959: 40,000 newborns die each year, including almost all premature infants, of a mysterious lung disease now called respiratory distress syndrome (RDS). John Clements and others show the cause: immature lungs lack soapy surfactant, needed to keep alveoli inflated as the infant breathes out.

1964: In work with Clements at UCSF Children's Hospital, William Tooley observes that the constant monitoring and care given to babies during research saves some lives. Tooley and head nurse Teresa Poirier found UCSF's pioneering neonatal intensive care unit. Studies begin on the long-term outcomes of babies who survive thanks to intensive care.

1965: UCSF Children's Hospital neonatologists and obstetricians establish the "set-up room" to treat newborns after birth. Premature babies and others at risk receive vigorous resuscitation before they are transported to the nursery.

1966: John Severinghaus and Freeman Bradley develop electrodes to allow readings of carbon dioxide (CO2) in small blood samples. UCSF Children's Hospital's intensive care nursery sets standards for monitoring blood gas and blood pressure as indicators of neonatal health, later leads studies of less invasive monitors.

1969: George Gregory invents CPAP - continuous positive airway pressure - to save a baby boy struggling to breathe with RDS. Survival rates for preemies improve dramatically - and for the first time, babies smaller than 750 grams (1.65 lbs.) have a chance at life.

1973: UCSF Children's Hospital begins a regular ethics conference on neonatal intensive care. Staff bring parents into decision making, with support and information about their infants' chances of survival, and the risks of later health complications.

1973: Obstetricians at UCSF Children's Hospital and elsewhere offer steroids to mothers in the first stages of pre-term labor. At birth, their babies can produce some lung surfactant on their own.

1974: Mechanical ventilators are fitted with a version of CPAP called positive end expiratory pressure (PEEP) - the first truly effective artificial breathing aid for newborns.

1975-76: Michael Heyman and Abraham Rudolph show that indomethacin can treat patent ductus arteriosus, a preemie's heart defect that otherwise requires surgery.

1981: Michael Harrison leads the first surgery on a fetus returned to its mother's womb. UCSF children's Hospital's ICN is the world's most experienced nursery in caring for babies born after fetal surgery.

1985: In UCSF Children Hospital's ICN, the first baby is treated with Exosurf, the artificial surfactant developed at UCSF by John Clements. Exogenous surfactant now is used daily for thousands of babies to aid breathing and prevent lung damage.

1987: Kevin Shannon and Rod Phibbs prove that erythropoetin, the protein that controls red blood cell production, can treat anemia of prematurity.

1960s - 1990s: Survival rates for preemies steadily improve. In the UCSF Children's Hospital ICN in the '90s, babies weighing 1500 grams (3.3 lbs.), who once had a 3-in-4 chance of death or serious impairment, now have a 98 percent chance of survival and a 9-in-10 chance of growing up without neurological problems. Survival rates for UCSF babies less than 750 grams are among the best in the nation. The smallest, sickest and most premature still are the greatest concern.

2000: A major National Institutes of Health-supported study seeks ways to prevent brain damage to babies who suffer brain injuries. A 22-year grant supports studies of the molecular developmental biology of lung maturation.