Teeny Tiny

Taylor Rideout born on March 12, 2009 now holds the world's record for being the smallest baby born alive and to survive. She weighed in at 12.5ounces or 350grams and was 10 inches long. She was born at Magee Women's Hospital in Pittsburgh, PA at 26 weeks gestation. Babies born before 37 weeks gestation are considered to be premature. Usually a baby is considered to be non-viable if they are born under 500grams and no heroic measure will be done to save their lives. Now that Taylor survived being born at 350grams, I suspect more parents will want everything possible done to save their micropremie. It is interesting that only 46 years ago the son of President Kennedy, Robert Bouvier Kennedy, died of respiratory distress syndrome or hyaline membrane disease. He was 34 weeks gestation and 2110grams or 4 pounds 10 1/2ounces. His death however is said to be a contributing factor to the creation of the first NICU at Yale-New Haven Hospital. Babies born with Hyaline Membrane disease in 2004 had a mortality rate of only 15%. What a drastic change in 40 years. Now infant's are given surfactant that has been derived from bovine or porcine lung extract. Surfactant has only been in use since the early 1990s.
There are an endless amount of complications that arise from "saving" smaller and smaller babies. These infant's are at high risk for developing mental and physical disabilities such as asthma, cerebral palsy, hearing and vision disorders. These tiny patients may try to die over and over again but technology at the hands of neonatalogist save them. Survival then becomes a question of ethics, what type of quality of life does the teeniest tiniest baby have. Since babies are not able to speak for themselves, who has the final say, the physician, parents or God?

Every Breath You Take

During a transport an infant's airway must be stabilized. The neonatal transporter has a built in ventilator. Sometimes a high frequency ventilation system is used such as the Bronchotron. This ventilator delivers 200-800breaths per minute. There are tanks for air, oxygen and even nitric oxide. Pulse oximetry will let us know the oxygen saturation and the cardio-respiratory monitor will give us the heart rate and respirations. Also built in is a suction machine, which helps to clean obstructions to the infant's airway. If the proper level of oxygen is not delivered it could lead to asphyxia, which is a condition in which there is a significantly reduced oxygen supply to the tissues with build-up of carbon dioxide and lactic acid. This could lead to cell and organ damage, which in turn could lead to survival with damage or worst case scenario, death. What a drastic change the transport incubator has undergone in the last seventy years.