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Respiratory Care
The neonatal intensive care unit at Babies and Children's
Hospital is skilled in a wide variety of tech. In addition to the
neonatology faculty and support staff, there is a full time neonatal anesthesiologist
(Dr. Jen Wung) who assists with the care of infants needing respiratory
support. Our intensive care unit has been recognized by the National
Institute of Health for its extremely low incidence of chronic lung
disease.
ECMO
Extracorporeal membrane oxygenation (ECMO, or extracorporeal
life support) uses a constellation of biomedical devices that reproduce
the functions of the heart and lungs. This technology provides sustained
life support for selected newborn and pediatric patients; these children
are often suffering from overwhelming respiratory or cardiac failure which
has proved refractory to other treatments. For newborns, the therapy is
not unlike returning the infant to his mother's placenta, for a more gradual
transition to breathing air.
Since 1982, the Center for Extracorporeal Life Support at Babies and Children's
Hospital has been directed by Dr. Charles Stolar in the Division of Pediatric
Surgery. The Center was the third in the world to successfully support a
neonate. More than 2,500 infants have been referred as potential ECMO patients
from 47 institutions throughout the Tri-State area and the Mid-Atlantic
region. To date, 175 infants and a smaller number of older children have
been treated with ECMO, of whom 84% are at home with their parents.
However, ECMO is only part of the respiratory care strategy in the Neonatal
Intensive Care Unit, which is itself a unique resource. Respiratory failure
is the most common cause of death and complications in the newborn. The
Neonatal Intensive Care Unit at Babies Hospital has earned an international
reputation for excellence in respiratory care, which rests on our results:
the frequency of chronic lung disease in premature infants treated in our
unit is the lowest in the United States. We have a particular interest in
newborns with congenital diaphragmatic hernia. By designing a protocol focused
on the gentle support of the fragile lungs of these babies, we have been
able to turn a mortality rate of 50% into a survival rate of 92% for patients
with this condition.
Neonatal
Nutrition Support
Director:Sudha Kashyap, MD
Nutritionist: Joanne Carroll, RD
For decades Children's Hospital of New York, has been in the forefront
of pediatric/neonatal rehabilitation. Major contributions have been made
by our staff to fields of neonatal parenteral and enteral nutrition.
In our neonatal unit the Nutrition Support Service is strongly represented
on a daily basis. There is a neonatal nutritionist and a neonatologist
that specializes in nutrition research.
The nutritionist is an integral part of the neonatal team. She rounds
daily with the Attendings, Nurse Practitioners, and Residents to offer
recommendations to optimize the nutrition care of the sick neonate. The
nutritioinist also provides in-service to the house staff on theory and
rationale of nutrition principles.
Nutrition assessments, goals and plans are evaluated on a weekly basis
for neonates on parenteral nutrition and monthly for enterally fed infants.
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