The first 24 hours in NICU can be a critical time for baby. Baby will be placed on a ventilator and will be constantly monitored by the doctors and nurses on the unit. There will be a lot of noisy equipment around as well as other sick babies and this can be distressing. The Doctors and nurses will explain what the equipment is doing for baby and how baby is doing.
Depending on baby’s needs, the ventilation method could be conventional or HFOV (High Frequency Oscilation Ventilation). Sometimes baby can stabilise quickly, but also his or her condition can deteriorate just as quickly.
Some babies who are placed initially on conventional ventilation may be transferred to HFOV, which is a more ‘gentle’ form of ventilation and is therefore less likely to damage the residual lung (existing good lung). The baby may also receive inhaled Nitric Oxide (INO) which assists in the treatment of respiratory failure.
A rescue therapy called ECMO, (Extracorporeal Membrane Oxygenation) may be discussed if baby is failing on ventilation, which is basically a lung, heart bypass machine. This allows the baby’s lungs to rest whilst supporting baby’s life. There are only a few of these machines available in the UK and there is a certain criteria required before a baby can be considered for this treatment, as it is not suitable in all cases.
There is no current medical evidence to support that the use of ECMO is beneficial as a standard treatment to babies with CDH and most centres use the ‘Gentle Ventilation’ method.