In my NICU and in most NICUs around the country, babies who are born before about 27 weeks are placed on a ventilator at birth. Settings on the vent are gradually weaned until the baby is ready for CPAP or a nasal cannula.
New research, though, is showing that micropreemies may do better if they are placed on CPAP immediately after birth. Although most very small or very young preemies will eventually need to be intubated and placed on a ventilator, as many as 17% may never need the ventilator at all. Babies who do need a ventilator need it for shorter periods of time and have fewer side effects such as lung infections and lung scarring.
This new research is exciting - it's kind of radical to imagine a 24-weeker who never needs to be vented. The researchers plan to follow up when the babies in the study are toddlers, to see if there is a difference in the number of long term complications of prematurity these babies face.
My only problem with the study is the CPAP equipment itself. The delicate skin around the nose can break down quickly if the CPAP mask or prongs don't fit well, and getting a good fit is very difficult with some CPAP equipment. I'd love to hear from any readers who have a micropreemie who never needed the vent, or from parents with strong positive or negative feelings about CPAP!
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