It was their expertise in the latter—
refrigeration—that led to a serendipitous
union between industry and healthcare and
unexpectedly thrust the company into the
world of manufacturing medical devices.
As it turns out, the products they make to
keep food cool for long periods of time are
also effective in lowering the body temperatures of sick newborn babies—a proven
medical treatment for children born with a
condition called birth asphyxia.
Birth asphyxia, or lack of oxygen at birth,
is one of the leading causes of infant mortality in low- and middle-income countries. The
World Health Organization estimates that
650,000 babies worldwide die from birth
asphyxia each year, though the number of
annual instances is notoriously underre-ported, especially for children who survive.
The overwhelming majority of cases—more
than 95 percent—occur in less-developed
parts of the world. Many mothers from these
areas lack access to skilled medical care
during pregnancy and childbirth. The result is
an increase in injuries to newborns during the
Babies who survive the condition often
suffer serious and irreparable brain damage
that can result in lifelong physical and
mental disabilities. Cerebral palsy is among
the most recognized of these.
Permanent damage to the brain can be
reduced or prevented simply by cooling the
child’s body to sub-normal temperatures
immediately after birth. There is a long
history of scientific literature demonstrating that temporary, controlled hypothermia
can benefit newborns that have suffered
from hypoxic conditions. The treatment
involves cooling a baby from a normal 37
degrees Celsius (98.6 degrees Fahrenheit)
to between 33 and 34 degrees Celsius and
maintaining that body temperature over 72
hours. This type of treatment is regularly
used on adults who suffer strokes or other
ischemic brain injuries, and the rationale is
the same: a drop in temperature reduces
metabolic activity, thus reducing the
body’s overall oxygen requirement. For a
brain that has been deprived of oxygen,
minimizing the amount of oxygen needed
to function mitigates neural cell injury and
THE TREATMEN T DISPARI T Y
The technology for inducing controlled hypothermia already exists and is commonly used
in top tier global hospitals for both children
and adults. These sophisticated temperature control systems operate by wrapping a
patient in a blanket perfused with a chilled
fluid. The patient’s core temperature is then
continuously monitored, and the temperature of the fluid automatically adjusts to
fluctuations in body temperature. In such
fully-automated systems, a reduction in core
temperature is obtained quickly and is accurately and reliably held at the desired level
with little to no human intervention.
But these systems, while extremely effective, are also very expensive, costing upwards
of US$25,000 each. This price renders them
far out of reach for many hospitals with limited
Out of necessity, physicians in low-resource
hospitals and clinics often look to a cruder
method for cooling asphyxiated babies: ice.
Specifically, frozen gel packs. With some
practice, caregivers are able to use the same ice
packs that might be used to prevent swelling in
a sprained ankle to achieve the same therapeu-
tic benefits that more sophisticated systems
for controlled hypothermia accomplish.
Hospital and clinical staff freeze or refriger-
ate the gel packs to below the target body
temperature and then layer them between
blankets around the baby.
This method has a number of limitations,
however. First, it induces cooling more slowly
than desired, particularly in warm weather
geographies or facilities that are not fully
climate controlled. Also, it is difficult to control
the set temperature with ice packs, so newborns must be constantly monitored by nursing
staff to make sure they do not become overly
cold or warm. Common side effects from this
method of treatment are ice burns on the skin
or allergic-type reactions to cold.
Neonatologist Niranjan Thomas is well
aware of the challenges. Dr. Thomas first
began experimenting with gel packs as a
cooling treatment nearly a decade ago at
the Christian Medical College in Vellore, in
India’s southern state of Tamil Nadu, where
he heads the department of neonatology.
Thomas says he first became aware of the
benefits of hypothermia for asphyxiated
babies while working abroad in Australia and
Canada. But when he returned to India in
2007, he discovered that the practice had not
been adopted there, despite overwhelming
evidence of its effectiveness.
“At the time, no one in India was cooling
Physicians in low-resource hospitals resort to crude
babies, so we started using the cool gel
packs,” Thomas recalls, but adds that he
quickly became frustrated with the results.
“It was very labor intensive. There were
huge swings in temperature. It was not at
“In low-resource countries like India, we do
not have the level of nursing that is available
in the West. When you are using cool gel
methods to treat birth asphyxia, like ice packs.
Pluss Advanced Technologies has not always been in the business of saving babies. The India-based materials research and development company built its name making products that are decidedly less heroic sounding: specialty polymers that are used in products like flexible packaging and composite deck material, and designer chemical mixtures that hold heat
or cold for the purpose of refrigeration, food delivery or pharmaceutical transport.