Big problems for small lungs  pg. 5

 
William Walsh, M.D., director of nurseries at the Monroe Carell Jr. Children’s Hospital, examines a preterm infant in the NICU.
Photo by John Russell
“We see it all the time,” said William Walsh, M.D., director of nurseries at the Monroe Carell Jr. Children’s Hospital. “Often these babies born at 24 or 26 weeks do well for a couple of weeks, and then they begin to decline, no matter what you do.”

Payton Wilson was supposed to be a miracle baby. She was delivered on Aug. 17, 2008, at a mere 24 weeks of gestation in order to save her mother, who had developed a heart problem in pregnancy. Payton was on the highest level of respiratory care since day one, yet somehow she kept bouncing back from crisis after crisis.

A year later, Payton was finally preparing to leave the NICU when she suddenly went into heart failure and could not be revived. Nikki Wilson says she lost her daughter less than 15 minutes before she would have turned 1. It was the day before she was to come home for the first time.

Losing babies like Payton is devastating for parents and incredibly hard on everyone who cares for them.

“We have at least one or two babies like Payton in our NICU all the time,” says Chris Lynn, RRT, who has been a respiratory therapist and educator at the Children’s Hospital for many years.

He is painfully and constantly aware of the thin line between supporting a baby and prolonging damaging treatments. Currently, however, it appears the new BPD may be a price of survival.

Role of infection

A retrospective study of 4,065 very low birth-weight infants treated in 1998, 2001 and 2006 at eight NICUs found that survival rates climbed after ventilator use was cut and CPAP and surfactant use increased. But the proportion of babies who developed BPD also rose -- from 25 percent to 29 percent, the researchers reported in the March 2010 issue of Pediatrics.

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