Oxygen therapy in the NICU is routine as usual for babies born at early gestation and the staff that cares for them. Below you will find the reasoning behind such treatment, as well as the various forms through which it may be provided to the world's smallest patients.
The Reasoning Behind Oxygen Therapy in the NICU
All aspects of neonatology, the medical study of premature and high risk infants, are relatively new. Advancements are being made rapidly, and one of these involves oxygen therapy in the NICU. The doctors and nurses working in the preciously unique field of neonatology often go to extreme measures to rescue their tiny patients, and this often includes breathing for them when they are unable.
Preemies may receive oxygen therapy for a variety of reasons; however, it is most common in babies born with underdeveloped lungs or cardiac issues. The younger the infant at time of delivery, the more likely they will spend time with some form of oxygen treatment. Those born after 25 weeks gestation have a fighting chance; however, those who are very young and small, and remain on breathing assistance for long durations of time, may encounter other negative health effects such as vision problems and brain conditions. Many of these are treatable and reversible, though the prognosis varies from baby to baby.
Premature babies will almost always receive oxygen therapy following a surgery which requires them to go under general anesthetic. With small systems and little defenses, the majority of babies under 6 months of age will stop breathing on their own in response to the anesthesia administered to them. For this reason, a surgery team will usually intubate an infant prior to operating, which involves placing a tube down into the airway passage in order to breathe for the infant until the anesthesia wears off.
Since receiving oxygen, like many procedures, involves a distinct amount of risk, neonatologists now use a system that is called POLAR. This stands for Preemie Oxygen Levels Are Reviewed. It's used for infants weighing in at less than 1500 grams and involves providing them the least amount of oxygen that is feasible. POLAR has reportedly reduced the issues related to oxygen therapy, such as chronic lung disease and retinopathy, which can blind young babies.
Types of Oxygen Therapy
There are a few forms of oxygen treatment available to at-risk newborns.
The most extreme of the oxygen therapy options, a ventilator is simply a machine that moves air in and out of the lungs via compressible pressure. It can provide oxygen, but also room air, which is a step up toward breathing independently. The machines are monitored through a series of alarms and computer assists.
Continuous Positive Airway Pressure
A continuous positive airway pressure machine, also known as a CPAP, is used to prevent apnea in preterm and intensive care infants. It includes a flow generator, a hose that is connected to the generator for easy administration, and a nasal mask known as an interface. Sometimes a humidifier is also used to add moisture into the air being given.
One of the lowest forms of oxygen administration, the nasal cannula is often seen in films and TV shows when patients are in the hospital. It is also used on tiny babies, as a way to provide extra breathing assistance to one who needs a bit of extra oxygen. Plastic prongs are inserted into a baby's nostrils, and tubes fasten behind the ears. It is connected to either an oxygen tank or a flow meter that carries a designated amount of oxygen through the tubes and into the nose each minute.
Babies receiving oxygen therapy in the NICU often benefit greatly and regularly go home to lead normal and healthy childhoods. Each case is evaluated on an individual basis, but as advancements are continually made, more and more children are given a fighting chance at life.