Any 22 weekers out there?

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last night in our level 3 unit, out team with over to l&d for a code. it was for a 22 and 3/7 weeker! they coded that poor kid for 50 mins:mad:. has anyone ever heard of this? has any one taken care of an infant under 23 weeks and it lived even an few days. after 26 years somedays i just wounder what is next. how low can we go?!:confused:

Specializes in Developmental Care.

NRP specifies that there are no state or legal requirements for resuscitation age.

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Specializes in NICU, CVICU.

We have had one survive and do well. I don't remember the details.

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We had 3 sets of 22 week twins last summer. One of each passed away and the other survived. One I honestly don't remember the outcome, one was a pretty poor outcome but survived. The third survived amazingly well. Either no or grade 1 head bleeds, no or minimal ROP. Went home on a cannula and is still on a cannula at 14 months but not much flow. She's crawling and smiles and seems sharp.

She was a definite 22 weeker because she was IVF. She honestly changed my mind about resuscitating 22 weekers. Now I say give them a chance. See how they come out.

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Specializes in NICU.

An IVF 22 weeker would be a bit more mature (further along) than a 22 weeker with dates counted from LMP. Possibly 2 weeks more mature.

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Specializes in Nurse Scientist-Research.
An IVF 22 weeker would be a bit more mature (further along) than a 22 weeker with dates counted from LMP. Possibly 2 weeks more mature.

Just depends on individual practices. Our physicians date per LMP, or from presumed conception date + 2 weeks. If we had a "22 week" IVF kid, it would have been conceived/implanted 20 weeks before.

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I have handled the baby few weeks back who was 26wog,the tone was good as well as the breathing was good too so we intubated and kept the baby in incubator with special monitoring.But after the counselling to the parents,they decided to withdraw care.We should care about the morbidity as well not only about mortality.Baby may live but with the need of special care for the whole life?I dont think any human would want that.We dont take the neonate before 25wog or at least not taken till now.

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Specializes in NICU.
I have handled the baby few weeks back who was 26wog,the tone was good as well as the breathing was good too so we intubated and kept the baby in incubator with special monitoring.But after the counselling to the parents,they decided to withdraw care.We should care about the morbidity as well not only about mortality.Baby may live but with the need of special care for the whole life?I dont think any human would want that.We dont take the neonate before 25wog or at least not taken till now.

What morbidity did the 26 wk baby have besides respiratory? We routinely take babies 24-25 wks and there is no discussion of withdrawal of care based strictly on intubation and age.

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i was talking about the morbidity after on if the baby lives. :)

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Specializes in Nurse Scientist-Research.
I have handled the baby few weeks back who was 26wog,the tone was good as well as the breathing was good too so we intubated and kept the baby in incubator with special monitoring.But after the counselling to the parents,they decided to withdraw care.We should care about the morbidity as well not only about mortality.Baby may live but with the need of special care for the whole life?I dont think any human would want that.We dont take the neonate before 25wog or at least not taken till now.

What morbidity did the 26 wk baby have besides respiratory? We routinely take babies 24-25 wks and there is no discussion of withdrawal of care based strictly on intubation and age.

I believe Anupandey203 may be from Nepal. The age of viability is often much lower in low-resource countries. When some of our nurses have traveled to rural Central America they were told that the age of viability (and therefore resuscitation) was 34-35 weeks.

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Specializes in Community, OB, Nursery.
What morbidity did the 26 wk baby have besides respiratory? We routinely take babies 24-25 wks and there is no discussion of withdrawal of care based strictly on intubation and age.

My guess is that this poster may be from somewhere outside the US where NICU care practices and capabilities may be different.

When I was in Nicaragua, I asked the OB attending at a teaching hospital in their second-largest city what the cutoff was for resuscitation....28-30 weeks depending on what baby looks like. She knows that many places resuscitate earlier but they just don't have the capacity to resus the microchips nor the infrastructure to meet the long-term care needs so many will have.

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Specializes in NICU.

I know this is old, but I'd like to update:

It's rare, but we have sent a handful of 22 weekers home on room air and nippling. Two of them periodically update us, the kiddos seem to be developmentally on track. Now, I don't know what's going on behind the scenes, but it does change my perspective regarding resuscitating 22 weekers.

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Specializes in pediatrics.

Anyone working in the NICU should be required to work for 6 months caring for former micro preemies in the home (first). The 3 year olds, 10 year olds, 30 year olds. The trachs, vents, autism, severe learning disabilities, seizures, severe cerebral palsy, severe cognitive delays. . the on-going shunt and orthopaedic surgeries - the pain inflicted upon the survivors, the damage to marriages and families. It changes one's perspective dramatically.

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