24 weeker - how bad is it? - page 3

by goats'r'us

a friend of mine has just had her baby at 24 weeks 4 days. as a theatre nurse, all I know of preemies is their tendency to develop NEC, so can someone please give me the lowdown - obviously this is not good, but how bad is it?... Read More

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    Quote from TiffyRN
    Really with a 24 weeker, they will always be referred to (in report) as "a former 24 weeker". At least while they are in the NICU.
    Believe me, longer than just in the NICU. A lot of neuro deficit is wait and see. The heart/lung stuff that doesn't pop up until after discharge usually shows up pretty quickly. GI stuff tends to make itself known before NICU discharge. It's the neuro stuff that will get them though. Because if that's not good, the other systems will eventually go down with it. But it's hard to tell if they've got a deficit and/or how much it can improve for a few years. I'd agree with the above, university is a bit long, starts school would be about right.
  2. 0
    I was being a bit silly with the 'starts university' bit. what I'm really asking is in terms of survival, rather than appearance of deficits.
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    ooops. Yea. I am a ER nurse. Thanks for clarifying.

    Quote from babyRN.
    Do you mean a level III NICU? Level I is a nursery
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    Another sad reality is that the first day or week can be a "honeymoon" period, with the baby cruising along on low vent settings and 21% oxygen. Fast-forward 10 days and the same baby may be on the oscillator, 60% oxygen, on a dopamine drip, sedation and still drops O2 sats to nothing & gets bradycardic with a diaper change. It's a LOT of ups and downs for the first month, often two. It's two steps forward, one step back, two steps forward, three steps back, one step forward and so on.

    Talking with our NICU grad moms...they say they appreciate the people who acknowledge and validate their feelings. They often do NOT like to update people with each day's changing medical status, sometimes because there are days with no changes (no progress) and also because of the ups and downs (they don't like reporting 'bad' changes). Practical help like meals, childcare for the sibs is usually welcome - though IIRC, you are not geographically close to your friend.
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    Thought of your friend last night when we were dealing with a circling 23.5 weeker. Pray everything is better for you all. Very exhausting and emotional night. *sigh*
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    Sadly I saw an ex 24 weeker, then 43 weeks, 2 days from discharge, get NEC, perf and die all before lunch (his last PO feeding being at 6am). You never ever know with these kiddos.
    twinkletoes53 and wooh like this.
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    well, little lady is still hanging in there. a few days ago dad got to touch her for the first time, then the next day mum got to change her nappy, and yesterday mum got to have her first 'cuddle'.
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    Last edit by TheMiss on Feb 6, '12 : Reason: deleted
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    Goats'r'us - Australia and the US have different categories how we divide our baby nurseries. In Australia a level III nursery is the highest level offering most advanced care to the youngest and sickest babies. Your friends baby will be in a level III nursery where she receives the best possible medical and nursing care. Australia is one of the most advanced countries when it comes to neonatal medicine.(I reckon she's not in Alice) If your friends child has a chance on live - than that is where she is right now. Nobody will be able to predict outcomes - most infants who are majorly affected will show so by missing big milestones and are usually diagnosed by age two with cerebral palsy. Mild learning disabilities can still show during the first few years at school and if they actually go to uni they are probably among the little miracle group.
    Hang on in there mate...
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    Quote from GoddessLilithLPN
    My twin and I were born at 23 weeks gestation in 1984. We both survived and are completely healthy. My twin unfortunately developed ROP and now is completely blind. She has had her right eye removed due to severe glaucoma and can't see anything out of her left eye. She was in the NICU for the 4 months after birth and sent home with o2, I was in for 3 months after birth. Other than her having the ROP, we are both completely healthy..it's weird actually, I can see scars on both of our wrists from all the ABGs they did in the first few months of life. So think positively...things always turn out okay
    No, things do not always turn out right! Yes, there are a few miracles here and there.The ones the media focuses on. But there is the vast majority that ends up not just fine with varying degrees of intellectual and physical disabilities. Go and ask those moms and dads who suffered through month and years of ICU and have a quadriplegic, trachy, peg, child with seizures at home who can neither sit,talk, walk, nor eat,play or relate to anyone. Who burnt through all the families and extended relatives funds for all the medical bills. Ask if they agree with your statement. We don't know what psychological damage we do to the microprems neither. They suffer through NICU. There is so much pain and so much stress which we can't address.
    A 24 weeker can turn out okay and those are the ones everyone hopes for- but some times it is in the best interest of the patient to cease treatment.
    Ashley, PICU RN, BabyRN2Be, Mimi2RN, and 3 others like this.