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More than 80% of babies now survive, despite being born 4 months early
(HealthNewsDigest.com) – COLUMBUS, Ohio) October 2012 – New guidelines designed to care for extremely premature babies, also known as small babies – those born around four months early, are showing remarkable results by helping more of these babies survive than ever before. Just a generation ago, the survival rate for small babies was only around 10 percent, “but our rates of survival continue to go up,” said Edward Shepherd, MD, section chief of Neonatology atNationwide Children’s Hospital. “In 2011, our rate of survival was 84 percent, which suggests that the changes we made are long-lasting and likely to be sustained.” The changes are the result of a new set of guidelines, developed and implemented at Nationwide Children’s Hospital in 2004. Before that time, many people doubted that babies born before 27 weeks had much of a chance to survive. Even if they did, most assumed that these children were certain to face nearly insurmountable medical problems throughout their lives. “But we didn’t take that attitude,” said Dr. Shepherd. “Our approach was that every one of these kids has enormous potential for normal outcomes. So, we set out to convince people that these children who, while they had many, many challenges, could turn out to be normal,” he said. The first step was to take inventory of how these children were being treated, and try to standardize it. “We tried to make it as holistic as possible,” said Dr. Shepherd. “We included everything from how we care for them while they are transported to our hospital, to how we care for their skin. We looked at how we care for their oxygen levels and their ventilators. We even took into consideration the humidity levels in their cribs – everything we could think of, so that each baby would get the same level of care as every other baby got.” Then, experts took a look at those who were caring for these babies, and decided to include more specialists. “It’s very multi-disciplinary,” said Dr. Shepherd. “In addition to physicians and nurses, we may include everyone from cardiologists to respiratory therapists to nutritionists,” he said. “We think that’s a real strength of our approach.” Once the care teams were set and the guidelines were in place, experts put them to the test. Between December 2004 and August 2008, they applied the guidelines to 227 babies. “The average baby in this study was born at just 24 weeks, so these were the sickest of the sick,” said Dr. Shepherd. Despite that, survival rates surged. The study, published in the Journal of Neonatal-Perinatal Medicine, showed that in just three and a half years, the guidelines helped boost survival rates to 78 percent. Today, those numbers continue to climb to 84 percent. Nicholas Metz was one of the babies who benefited from the guidelines. Just 24 weeks into her pregnancy, Melissa Metz underwent an emergency appendectomy, and as a result, an infection spread to her baby. In a desperate effort to save him, doctors delivered Nicholas via C-section more than three months early. “He was one pound, 11 ounces and only 11 inches long,” said Melissa. “I didn’t even know babies could be born that small.” “It was very scary,” said Mark Metz, Nicholas’ father. “His lungs weren’t developed hardly at all. The doctors said he couldn’t take in any air, so he basically had to be intubated as soon as he was born,” he said. Over the next four months, Nicholas would make slow and steady progress. “We came home on July 4th,” said Melissa. “It was exciting, and very fitting, because Nicholas was celebrating his own personal independence day, as well.” Today, Nicholas is a happy, healthy toddler who continues to make remarkable strides. “He’s dad on the outside,” said Mark, “but all mom on the inside. She’s really tough, and so is he.” The Metz family says his progress is due, in large part, to the care team at Nationwide Children’s Hospital, and in innovative guidelines they’ve developed. “There is solid evidence that the care a baby gets in the first hour of life can make a difference in what that child will be like when they 3 or 4 – or even 10 or 20,” said Dr. Shepherd. “We just want to make sure that we’re doing the right thing at every turn in caring for them, and it’s literally hundreds of people who interact with that child before they go home.” Getting all of those people on the same page and caring for each child consistently is just what these guidelines are intended to do. |
