Any 22 weekers out there?

NicuGal, MSN, RN · Jun 5, 2015

Thanks, I'll tell you, sometimes there are worse things than dying. Everyone is totally stressed over all this, coupled with over capacity census. Ugh.

Jensmom7, BSN, RN · Jun 5, 2015

I tried NICU after 10 years as a Pediatric Nurse. I lasted 3 weeks. I think it was all the NICU "success" cases that I just knew would soon be Pediatric failures.

lconnett · Jun 5, 2015

I have read through the majority of this post with comments how the medical team tells the parents that resuscitation or intubating is unnecessary/more or less pointless. Honestly, it makes me so sad. HERE'S WHY:

I was born at 23-24 weeks in 1986. I weighed 1 pound, 12 ounces. I had a long 3 month battle in the NICU and was on oxygen for a full year after leaving the hospital to go home. The doctors explained to my parents that I would probably be blind (my eyes were still fused), deaf, and/or have cerebral palsy. Since my lungs were obviously so under-developed, I would blow holes in them several times throughout my NICU stay, and I would have to be rushed to emergency surgery to repair them. My parents were warned that this typically causes brain bleeds, which can of course lead to a host of other complications/issues. The scans ran on my brain after every surgery consistently reported NO brain bleeds at all.

There's always room for a miracle. I was more or less a guinea pig in 1986. From what I was told, they had to guess and estimate the best dosages for my size and weight, and experiment with different medications, etc. I was born in San Antonio at one of the best NICU units in Texas.

I had no choice in any of my treatment, obviously, but I fought. My parents fought. My NICU nurses and doctors fought for me. And more than that, I was covered in prayer. God can still perform miracles and I know without a doubt that I am one of them.

I pray for every NICU baby you guys come into contact with. A NICU miracle doesn't always mean a disaster is waiting to happen down the road, although I realize that may be your "norm". My main problems as a grown woman? I have slight scoliosis, wear contacts since my vision is so bad, and have a thyroid problem. I live a full, normal life, am happily married, and am going back to school for a second bachelor's degree for Nursing. Thanks for taking the time to read this.

morte, LPN, LVN · Jun 5, 2015

apparently not all persons use same method of calculating fetal age, are these 22 from conception or last period?

Luckyyou, BSN, RN · Jun 5, 2015

To the PP, please understand that your story is NOT the norm (although I'm sure we all wish it was). Powell and colleagues published "Decisions and Dilemmas Related to Resuscitation of Infants Born on the Verge of Viability" in 2012, and state a survival rate for 23 weekers of 8 to 33%, and 22 weekers a dismal 1 to 15%. Profound disability is seen in 87 to 98% of 22 weekers, and 67 to 93% of 23 weekers. I wish our medical team better explained to parents the road they are on when they beg us to "do everything" to save their baby.

TiffyRN, BSN, PhD · Jun 5, 2015

apparently not all persons use same method of calculating fetal age, are these 22 from conception or last period?

General practice in neonatology is weeks after last period, but the general public probably doesn't do this. So we really aren't comparing apples to apples when some of them talk about their "miracle" 23 weeker with no deficits that we would have called a 25 weeker. 25 weeks is a world of difference from 23.

NicuGal, MSN, RN · Jun 6, 2015

PP, I've been in practice for 30 years, you were most likely older, more near 25-26 weeks as we would have never ever thought of bringing a 23 Weeker back to

NICU. We did get some 24 weekers but they had to be greater than 500gm to be considered for NICU care. You are very lucky to have come thru pretty unscathed!

Unfortunately, we just don't have much to work with when you are 22 weeks. At least at 24 weeks you have some alveoli and your kidneys can function, 22 weekers are just not equipped for a good outcome.

BabyRN1023 · Aug 28, 2015

This happens all the time at my level IV NICU. Yes, the parents don't have all the information to make "the right" decision with these kids. Unfortunately, as nurses, we aren't allowed to tell them what the road of a 22 weeker looks like. Our doctors rarely arm parents with the info they need to keep their infant from suffering. They always say, "Yes, I've seen a kid like this live before." They never mention what kind of life it is for the baby or the parents. Just because we can, doesn't mean we should.

prmenrs, RN · Aug 28, 2015

Sometimes, the Docs talk to the parents, advising what the physiologic situation is (that 22wks is not compatible w/life, 22+ likely to die, have severe handicaps, all the scenarios possible. They might be in parents room more than once, each time going over the situation.

Parents might agree to not be aggressive, let nature take it's course, etc., understanding the risks. Then the baby comes out and gasps, which sounds like a cry, mom and dad instantly say, "Help him, he's crying, he's trying to live." It's very emotional, and the family thinks the docs have been less than truthful w/them, because baby seems to be alive. The baby is intubated, brought to the NICU, and things spiral out of control.

It's always a very complicated situation.

wensday, MSN, RN, APN, NP · Sep 3, 2015

50mins! Oh my days that's ridiculous for any baby, never mind such a prem. Sad that mum couldn't have that time holding her baby.

nja06, MSN, RN, APRN, NP, CNM · Sep 10, 2016

Wow this makes me so sad. I feel for you!!

TiffyRN, BSN, PhD · Sep 11, 2016

Our unit has started resuscitating some 22 weekers. So far, just 2-3. I know that one of the first didn't make it more than a couple of days. Last I checked, another one is staying steady on the jet. We'll see. We were told to anticipate that 90% of them will not survive the first couple of weeks. The justification is that according to the literature, of those that survive, their outcomes are on par with 23-24 week infants so it is reasonable to give them a chance.