LH - Centers & Programs - Neonatal - Correcting Breathing Problems

The neonatal professionals of the Neonatal Intensive Care Program at Lankenau Hospital utilize a variety of special procedures to alleviate breathing and respiratory problems in premature babies and seriously ill newborns.

The heart and lungs interact in the exchange of fresh oxygen and waste carbon dioxide in the circulation of blood throughout the body. In premature and high-risk babies particularly, the lungs may need help to function on their own. Here are some of the breathing problems that we commonly face and deal with:

Apnea
Sometimes babies stop breathing for shorter periods and an associated slowing of the heart rates known as bradycardia may occur. This is common to premature babies, but usually is outgrown. Sometimes medication such as Theophylline or caffeine is given to stimulate the baby’s breathing to prevent apnea. Prior to discharge, infants with apnea are evaluated to determine their need for home monitoring.

Mucus
Babies in the NICU may be unable to cough up their own mucus; a nurse or respiratory therapist suctions it out for them. A very small catheter connected to wall suction is passed into the mouth or nostrils, or through a breathing tube in the throat. Since the procedure also sucks out some air along with the mucus, the infant may become dusky in color, and is given additional oxygen or breathes with a ventilator bag.

Oxygen Requirement
The normal oxygen concentration in a room is 21 percent. If a higher level of oxygen is needed it can be delivered several ways:

Relatively low oxygen levels can be administered by small catheters placed inside the baby’s nostrils. Higher levels, greater than 30 percent, can be given by means of an oxygen hood. This is a clear plastic tent placed over the infant’s head.

If an infant has a major oxygen requirement, several types of therapy may be used to provide adequate support. Continuous Positive Airway Pressure (CPAP) provides a constant flow of air and oxygen under pressure through special nasal prongs to help stabilize the air sacs in the lung. If the infant’s respiratory problems are more severe, the baby is placed on a ventilator to help the lungs regulate oxygen and carbon dioxide levels in the blood. This is done by adjustments in the oxygen concentration, breathing rate and/or the amount of pressure needed to deliver the oxygen to the lungs. For this purpose, a breathing tube is inserted into the windpipe through the mouth or the nose. The ventilator is connected to this tube. Babies cannot cry with the tube in place, but, as they improve, it is removed and their ability to cry returns. They then progress to CPAP or an oxygen hood for ongoing oxygen therapy.

Pneumothorax
Some babies may experience a lung collapse caused by an air leak that collects in the chest. To treat it, a chest tube is introduced through the chest wall into the space around the affected lung. It is connected to a special suction chamber that removes the air around the collapsed lung. This allows the lung to reinflate. The air leak usually heals within two or three days and the tube can then be removed.

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Contact Us
The Neonatal Intensive Care Program at Lankenau Hospital 100 Lancaster Avenue Wynnewood, PA 19096 610-645-2316

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