Big problems for small lungs

Helping little ones breathe may lead to long-term problems

Carole Bartoo
Published: June, 2010

The lungs are the last critical support system to mature before a baby is born, so when a baby is born too early, the lungs struggle to work before they are ready.

Fortunately neonatal care is now very good at helping support the breathing of premature infants, so good, in fact, that a baby just a few weeks past the halfway point in gestation can survive… but at what cost?

Protection of tiny delicate lungs, threatened by premature birth, is one of the critical areas of research in the Vanderbilt University School of Medicine’s Department of Pediatrics.

Joshua Speck plays at Nashville’s
Dragon Park after his clinic visit at
Photo by Susan Urmy

Joshua Speck runs the hallways of his Sparta, Tenn., home tethered to a 50-foot-long oxygen tube. He plays happily, constantly in motion, except when he gets hopelessly tangled.

“He’s always getting hung up with his tubing and saying, ‘Me stuck,’” says his father, Dennis Speck. “Nothing stops him and he’s not afraid of anything. You turn your back and he’s ready to climb up and jump off the furniture.”

Joshua weighed 585 grams at birth, or 1 pound, 4 ounces. He was born just 27 weeks into his 40-week gestation. Somewhere along the rocky road to his discharge from the hospital he was diagnosed with a serious chronic breathing disorder called bronchopulmonary dysplasia, or BPD.

Today, at the age of 3, he still cannot go more than two hours without his oxygen tube.

BPD is a chronic lung disease that occurs in 10,000 to 15,000 premature infants in the United States every year. Many of them are born with respiratory distress syndrome and require mechanical ventilation to help them breathe. The pressure and oxygen mix delivered by a ventilator can irritate and inflame their delicate lung tissues. Prolonged ventilator use is the leading cause of BPD.

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