Posts Tagged ‘endotracheal tube’

Meconium aspiration

Tuesday, September 21st, 2010

Meconium is the stuff that first poops are made of. It’s greenish-black, sticky and tar-like, but may be treated as gold because it shows that the baby’s intestines are working.

Sometimes the passing of the first stool happens while the baby is still in Mom’s uterus or during delivery.  Meconium aspiration happens when a newborn inhales (or aspirates) a mixture of meconium and amniotic fluid.  The inhaled meconium can partially or completely block the baby’s airways, making it difficult to breathe and causing meconium aspiration syndrome, or MAS.

If that happens, the doctor will order a number of tests to see how affected a baby might be.  The primary focus is to clear the airway as much as possible to decrease the amount of meconium that is aspirated. This is done by inserting a plastic tube into the baby’s windpipe through the mouth or nose and applying suction as the tube is slowly removed. This allows for suction of both the upper and lower airways. The doctor will continue trying to clear the airway until there’s no meconium in the suctioned fluids.

MAS can affect the baby’s breathing in a number of ways including irritation to the lung tissue, airway obstruction by a meconium plug, infection, and the destruction of surfactant by the meconium (read our previous post on surfactant.)  The severity of MAS depends on the amount of meconium the baby inhales and, generally, the more meconium a baby inhales, the more serious the condition.

Babies with MAS may be sent to a special care nursery or a NICU to be carefully monitored for the next few days. Most babies with MAS improve within a few days or weeks and usually there is not severe permanent lung damage.  These babies, however, may be at a higher risk of having reactive airway disease (lungs that are more sensitive and can possibly lead to an asthmatic condition).  Severe cases may necessitate the baby be given mechanical ventilation, which can increase the risk for bronchopulmonary dysplasia, a lung condition that can be treated with medication or oxygen.  Rarely, MAS can lead to a collapsed lung or pneumonia.

If not at the hospital when her water breaks, it’s important for a pregnant woman to tell her doctor immediately if meconium is present in the amniotic fluid, or if the fluid has dark green stains or streaks. Doctors may use a fetal monitor during labor to monitor the baby’s heart rate for any signs of fetal distress. In some cases they may recommend amnioinfusion, adding saline to the amniotic fluid to wash meconium out of the amniotic sac before the baby has a chance to inhale it at birth.

Although MAS is a frightening complication for parents to face during the birth of their child, the majority of cases are not severe.  Did any of you face this problem?

In the NICU – How does C-PAP differ from a ventilator?

Thursday, August 5th, 2010

help-breathing2Some premature babies are put on C-PAP to help them breathe. Others are on a ventilator.  What’s the difference?

In C-PAP (continuous positive airway pressure), air is delivered to a baby’s lungs either through small tubes in the baby’s nose or through a tube that has been inserted into her windpipe. The tubes are attached to a machine, which helps the baby breathe but does not breathe for her.  With C-PAP, the baby breathes on her own, but the steady flow of air coming in through the tubes keeps enough pressure in her lungs to prevent the air sacs from collapsing after each breath.  It’s a little extra support to help the lungs do their job.

A mechanical ventilator is a breathing machine that delivers warmed and humidified air to a baby’s lungs. The sickest babies receive mechanical ventilation, meaning that the mechanical ventilator temporarily breathes for them while their lungs recover. The air is delivered to the baby’s lungs through an endotracheal tube (a small plastic tube that is inserted through a baby’s nose or mouth down into the windpipe). The amount of oxygen, air pressure and number of breaths per minute can be regulated to meet each baby’s needs.

For those of you who had a premature baby, was she on C-PAP or a ventilator?  How did you feel when you saw the equipment?

 

Updated October 2015.