In recent times, advancements in neonatal care have revolutionized the management of pre-mature and sick infants, significantly improving their survival rates and long-term outcome. The preservation of the quality of life in high-risk infants is the current emphasis of neonatology, one of the medical specialties that has progressed by leaps and bounds.
1. Less invasive surfactant administration (LISA)
A promising approach – surfactant is given into the trachea by direct laryngoscopy, via a thin tube through the vocal cords, while the newborn remains on NCPAP. After surfactant administration, tube is removed. LISA results in reduced need for mechanical ventilation, Improved oxygenation, decreased duration of ventilation. By avoiding the risk associated with intubation and mechanical ventilation, LISA offers a gentler and safer alternative while maintaining the newborn’s natural breathing.
2. Advances in ventilation
a. High frequency oscillatory ventilation: Provides lung protective mode.
b. Non- invasive ventilator with synchronization: It combines CPAP with positive pressure during inspiration to improve the ventilation and lung health.
c. Inhaled nitric oxide therapy : It helps to improve the oxygenation in neonates with PPHN (persistent pulmonary hypertension of the newborn).
3. Bedside ultrasound and echocardiography
This has revolutionized the care of newborns in the present times and treatment is possible with much precision.
4. Advances in metabolic and genetic investigation
With the advancement of science and technology it is possible to rapidly confirm the diagnosis and start the treatment accordingly.
5. Developmentally supportive care
A range of strategies designed to reduce the stress of NICU which include reducing the noise, light, minimal handling, pain control.
6. Signal extraction technology for oxygen saturation
Non-invasive tool to monitor oxygen saturation accurately, thereby revolutionizing the care of newborns.
We have a terrific responsibility towards not just survival but intact neurological survival of sick neonates which is getting feasible with the recent advances. Quality nursing care remains instrumental in achieving these goals.
Dr. Prince Parakh
MD (Paediatrics), FISPN
Sr. Consultant Paediatrics & Neonatology
Neotia Getwel Multispecialty Hospital