NEONATOLOGY

Special NICU Programs

LUNG RESCUE

Newborns with life-threatening lung disorders may need specialized care and equipment located at one of our major hospitals in the North Shore - Long Island Jewish Health System. Our neonatal service provides the high level of support in the region including transport inhaled nitric oxide, high frequency ventilation, and ECMO (extracorporeal membrane oxygenation). Our faculty have been leaders in the development of high-tech, advance respiratory support for newborns with respiratory failure also known as persistent pulmonary hypertension of the newborn, that may be refractory to conventional medical therapy. If a baby, who is greater than 34 weeks gestation at birth with respiratory failure, still does not respond to advance support we provide ECMO. ECMO in most cases is a life-saving technique in which a heart-lung bypass system, circulating and oxygenating blood outside the body, allows the lung and heart of the baby to recover, even if the bypass is needed for days to weeks. A highly skilled neonatal, critical care and surgical team, as well as ECMO certified nurses are required for this life-saving therapy.

CURRENT CLINICAL TRIALS:

1. Selective Brain Cooling for Hypoxic Ischemic Encephalopathy. This is a very promising clinical trial to prevent a certain form of cerebral palsy that may occur after an obstetrical emergency in which the baby's brain may not have received adequate oxygen or blood flow. The cooling cap helps lower the baby's body temperature to about 94-95ºF, preventing the release or action of harmful chemicals produced by the body which may lead to brain injury.
   
2. Inhaled Nitric Oxide for the Prevention of Chronic Lung Disease. With recent advances in respiratory support, premature babies can be sometimes saved as early as 23 weeks gestation. One of the serious problems that develop in extremely low-birth-weight infants is chronic lung disease, which leaves the baby dependent on oxygen and ventilatory assistance for weeks to months. Nitric oxide is a natural substance (a gas) produced by our bodies that can help improve blood flow to the injured lung and can decrease inflammation that leads to lung scarring. Inhaled nitric oxide is an FDA-approved drug that can be life saving in term infants with certain forms of respiratory failure.
   
3. Immune Globulin for the Prevention of Late Onset Infections in Very Low-Birth-Weight Premature Infants. This clinical trial uses a special form of immune globulin, given intravenously, that appears to have great efficacy against certain "staph" germs. Premature babies are predisposed to developing serious infections because of their immature defense mechanisms. Decreasing infection in the small premature infant makes the hospital course far less complicated and shorter.