What Complication Might My Preemie Experience While In The Neonatal ICU?
Common Complications A Preemie May Experience
Premature babies often have medical problems because their organs and body systems have not developed sufficiently. The immune system, lungs, brain, and gastrointestinal tract are most often affected and pose the greatest risk. Because of these problems of prematurity, many babies who are born too small or too early need special care in a neonatal intensive care unit (NICU). Some babies can have serious difficulties, punctuated by repeated setbacks, but there are plenty of treatments for these complications.
An intraventricular hemorrhage, also called IVH, is bleeding into the ventricles of the brain. IVH tends to happen because premature babies have a very rich blood supply to their brains, but this blood mostly flows through extremely fragile capillaries. An IVH can be mild or severe, depending on how much bleeding there is. Fortunately, in most cases the the bleeding is mild, and resolves without causing problems. Some babies won't have any long term effects, while babies with more extensive bleeds might have developmental delays, permanent brain injury, or even death.
Unfortunately, there is no way to stop an intraventricular hemorrhage once it has begun. Treatment for IVH targets symptoms of the bleed, and may include increased respiratory support or medications for apnea and bradycardia.
About three quarters of all IVH's take place during the first five days of a preemie's life, and nearly all take place within the first 10 to 14 days.
A seizure occurs when there are abnormal electrical discharges in the brain. Most neonatal seizures occur over only a few days, and fewer than half of affected infants develop seizures later in life. Seizures in a premature infant can be so subtle that they're easy to miss. A seizure may occur because of an infection, imbalances in the usual substances found in the blood after a major IVH or swelling of the brain.
The most obvious symptoms are jerking movements of the body, stiffening of the arms, arching the back, sustained opening of the eyes with a fixed gaze, fluttering of the eyelids, and trembling of the mouth or tongue. A spell of apnea or sudden brief high blood pressure may also occur.
If the doctor suspects that your baby is having seizures, he will probably ask for an EEG or given anticonvulsant medication that acts as a calming sedative. But even EEGs can leave doctors unsure.
Meconium Obstruction is also known as inspissated meconium, which is simply a kind of severe constipation in very low birth premature infants. Meconiumn is the first kind of stool a newborn baby passes after birth. If meconium obstruction is not diagnosed promptly it predisposes your baby to intestinal perforation and prolonged hospitalization.
Symptoms include abdominal distension, vomiting, failure to pass meconium within the first 24 to 48 hours after birth, constipation, and rapid dehydration with associated electrolyte imbalance. This fetal stool consist of sloughed-off cells, amniotic fluid, bile, and mucus. It is black and thick, like tar. If meconium dries out, the bowel can become so distended that it perforates the bowel wall. In rare cases surgery is performed to prevent or repair a perforation.
When we breathe, air goes into our nose or mouth, down our windpipe, and into the many small airways and air sacs of out lungs. An air leak from a baby's lung can occur when some of the breathing sacs break causing air to leak into the space around the lungs. Air leaks happen mostly in premature babies or babies whose lungs are not fully developed. There are different kinds of air leaks, depending on where the air goes.
The most common air leak in newborn babies is called pneumothorax. Air leaks into the space between the lungs and the chest wall.
A serious pneumothorax must be treated. Air that gets trapped between the lung and chest wall must be removed because a large pocket of air will press on the lung, causing it to collapse. The doctor may pass a small drain through the chest wall to allow the air to escape, but if more air continues to collect a minor surgical procedure is required.
Patent Ductus Arteriosus (PDA)
All babies are born with patent ductus arteriosus (PDA). In preemies, however it's not uncommon for a PDA to take a lot longer to close. When a baby is still developing in the uterus, they have a short passageway or duct called ductus arteriosus linking two of the big blood vessel leaving the heart. Preemies are diagnosed with PDA from the sound of their heart heard through an ordinary stethoscope, the doctor may be able to hear the continuous murmur sound it makes or through an X-ray.
Although a large PDA can cause fluid to build up in the lungs, reduce blood flow to the intestines and other organs, and over time impede the strong pumping of the heart. When a preemie has a PDA and consequences show that it may cause a problem, doctors will usually try to close it by treating the preemie with medication. If a baby still has a wide-open ductus after two courses of medication, they will consider surgery to close it.
Babies usually do well after their PDA closes naturally or has been closed by medication or surgery.
Pulmonary Hemorrhages are more likely to occur in extremely premature babies with severe respiratory distress syndrome. Premature infants are at high risk of pulmonary hemorrhage because their lungs are not fully developed. The onset of Pulmonary Hemorrhage is characterized by oozing of bloody fluid from the nose and endotracheal tube.
Pulmonary hemorrhage usually needs immediate treatment. The first priority is to help the baby's breathing, keeping his lungs well inflated. The preemie may be given fluid, blood, or special medications to improve blood clotting or heart function.Sores From Tape
Sores from tape on premature babies will probably heal completely with no visable signs of scarring. A premature baby's skin is very delicate. Your baby's skin will be thinner than a term baby's skin. It will tend to be dry and flaky. With the ever increasing regeneration of new skin growth your preemie will eventually outgrow any irritations or breakdowns.
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