Emergency breathing support for a newborn girl
A newborn baby girl inhaled meconium from the amniotic fluid during her birth causing damage to her lungs and leaving her struggling to breathe.
She was quickly put on a ventilator and transferred by ambulance to the children’s hospital. Her lungs need increasing pressures to push oxygen across the damaged membranes into the blood and she is at very high risk of dying. The intensive care doctor decides that a short period on extracorporeal support will prevent further lung injury and allow the lungs to recover.
A perfusionist is called in along with a cardiac surgeon to put the patient onto a modified heart lung bypass circuit primed with blood. The baby is anaesthetised and given a small amount of heparin to stop her blood from clotting. She is connected to the circuit via her jugular vein and oxygenated blood flows back to the organs in her body through the carotid artery, bypassing the baby’s heart and lungs. As respiratory function is being provided by the extracorporeal circuit, her ventilator pressures can be reduced and her lungs can be rested for the next few days.
Circulatory parameters, biochemistry, blood pressure and blood-clotting status are constantly monitored by the perfusionist or a specialist ICU trained nurse. This is a delicate and high risk procedure. Some complications that can occur include coagulation imbalances, infection or extracorporeal circuit failure. The little girl’s lungs improve after 70 hours of extracorporeal support and she can be weaned from support. Her lung function now allows her to breathe via the ventilator again – but at much safer levels. She stays in ICU for a few more days, then is moved to a general ward and discharged home after two weeks.