Hospital

ABMH Uses HFV to Save 17-hour-old Baby with Respiratory Problem

The baby developed breathing difficulty soon after birth

Dr Sachin Shah

The NICU at Aditya Birla Memorial Hospital, Pune has breathed life into a 17-hour old baby girl with fatal respiratory problem with the help of an advanced High Frequency Ventilator (HFV) which provides High Frequency Oscillatory Ventilation (HFOV). It is one of its first kinds in Pimpri Chinchwad Municipal Corporation.

The baby was born by lower segment caesarean section in view of dropping heart rate and passage of faeces in womb. The baby developed breathing difficulty soon after birth and was transferred to a children's hospital. She was put on the ventilator at the children's hospital. However, the condition worsened. It was then that Dr Sachin Shah, Director Paediatrics and Neonatology, ABMH, received a call to intervene and save the life of the baby.

"She was diagnosed to have me-conium aspiration syndrome and pulmonary hypertension (a near fatal condition where the lungs and heart both do not function normally). After making the diagnosis, the baby was immediately transferred to the NICU of ABMH by trained team of doctors," said Dr Shah.

Transport incubator and ventilator were used to transport the baby. At ABMH, the baby was instantly put on the newly installed advanced high frequency ventilator and was given nitric oxide gas to decrease pressure in the lungs and improve the blood supply. "HPOV is used when the regular ventilator fails as it is gentler on the lungs and avoids complications during treatment," said Dr Shah. Dr Sachin Shah and Dr Pankaj Bhide of ABMH have been trained in the use of this machine/modality in Australia and Canada.

Using such advanced machines the faeces in the lungs were cleared, the blood flow to the lungs was improved and also the pressure on the heart was relieved. As a result, the baby started showed improvements. She received intensive treatment for six days, but remained on the ventilator for 10 days. She was discharged after two weeks.

"The oscillatory ventilation is characterised by high respiratory rates up to 15 hertz (900 breaths per minute). The rates used vary widely depending upon patient type and disease condition. HFOV generates very low tidal volumes that are generally less than the dead space of the lung. Different mechanisms of gas transfer come into play in HFOV compared to normal mechanical ventilation," said Dr Shah, explaining the mechanism of the advanced HFV.

"Nowadays, 10 per cent of the babies are born with such problems. I am glad that now we can save premature babies, the newborns and other children with acute lung diseases and other oxygenation issues such as acute respiratory distress syndrome or acute lung injury, who otherwise would not survive on the regular ventilator," he added.

EH News Bureau