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SAVING PREEMIES
Doctors are saving tens of thousands of infants who are born too soon or too small. Dr. William Fox, director of the infant intensive care unit at Children’s Hospital, says, “We’re getting 60 percent survival in babies who weigh less than 2 pounds. Ten years ago, only 1 percent of these infants lived.”
More preemies now survive because of ingenious advances in three crucial areas: diagnosis, feeding, and, perhaps most important, mechanical breathing. Such newborns often suffocated to death because their lungs, the last organs to develop, did not work well enough to absorb oxygen.
Diagnosis
Instruments can now detect changes in the preemie’s heart rate, breathing, oxygen supply, and temperature. Sound-wave pictures of the inside of the body, known as ultrasound or sonograms, allow doctors to examine the baby’s brain. Sonograms have revealed that the blood vessels of up to 40 percent of preemies burst and hemorrhage into the brain because of the too high pressure of the ventilators. Because the sonogram detects that bleeding, the physician – who sometimes walks a thin line between keeping the baby alive and causing brain damage – can take countermeasures.
Feeding
Preemies used to starve to death because their digestive system also had not reached maturity. They would throw up any food given to them. Now nurses feed preemies by vein with a special liquid mixture of protein, sugars, fats, and vitamins. This gives the intestines and stomach time to “grow up” before the baby is given ordinary food.
Scientists designed food pumps and feeding tubes (called catheters) so that the liquid food pours day and night into a large vein that feeds directly into the heart. The method is called hyper-alimentation, meaning “super-feeding.”
Mechanical Breathing
Doctors can now save most infants born with underdeveloped lungs. They place a tube into the baby’s airway and connect it to a machine called a ventilator that pushes oxygen into the lungs. In addition, new devices measure how much oxygen seeps into the blood. So the doctors can adjust the ventilator to deliver the most oxygen at the least pressure. Matthew Luccarella – like President Kennedy’s son Patrick, who weighed 4 pounds at birth in 1963 – was born with a film of fluid covering his lungs. It’s called hyaline membrane disease. Normally, an infant’s body makes a chemical that removes the film. The two boys lacked the chemical. In a week or so, with the help of the ventilator, Matthew’s body made the chemical to clear his lungs, and he began to breathe on his own. Patrick Kennedy, without the ventilator, died 2 days after birth.
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