Is This Still Done???

dawngloves, BSN, RN · Jul 26, 2004

Hmmm... I don't think I've heard of it. You don't mean Surfactant do you?

Gompers, BSN, RN · Jul 26, 2004

I've read about this in journals before. They've trialed using liquid oxygen mixed with saline, I believe. They'd instill this solution down the ETT and then I believe they might have used ETTs with inflated cuffs to form a seal so it stays in the lungs. Then they'd connect to a conventional ventilator. The liquid oxygen was supposed to improve oxygenation so that they'd be able to us minimal vent settings on micropreemies. It was a few years back that I read about this so I could be wrong on some points. It wasn't enough fluid to fill the lungs, though, it was something like 10cc/kg maybe.

I also saw a special on the BBC a few years back and I believe they used liquid oxygen on that, but it a total immersion environment. They did a c-section and delivered a pre-term lamb, then immediately put it into a tank of what I believe was liquid oxygen (mixed with saline or water, I forget) before it had the chance to breathe air. They wanted the lamb's first breath to be underwater - kind of like being a fish! I believe they inserted and sutured in umbilical lines for nutrition. I'm totally serious, I saw this! I wish I still had the tape...

I swear, I'm SO not crazy.

dawngloves, BSN, RN · Jul 26, 2004

Dude! I totally believe you! I swear, in about 30 years we'll put all micros in a tank of liquid oxegen and let them grow for 10 weeks! I can totally see it!

The thing I'd be concerned about withthe cuffed ETT for all that time would be trachial malasia (sp?).

Jolie, BSN · Jul 26, 2004

Partial liquid ventilation (PLV) to treat respiratory distress syndrome. Did it ever get beyond the "experimental" stage? Is this being used anywhere???
Thanks! :)

Liquid ventilation is still used, to my knowledge, in experimental settings. It was pioneered at Thomas Jefferson Medical Center in Philadelphia, and the first neonate to be treated (over 10 years ago) was a 24-25 weeker with little hope of survival. Out of sheer desperation over the inability to oxygenate the baby due to lack of alveolar development, the parents and neonatologists agreed to attempt liquid ventilation. The liquid used is not liquid oxygen, however, it is a substance called perflurocarbon (sp?), which is a liquid with a high affinity for oxygen. The liquid is instilled via the ETT, and the infant placed on mechanical ventilation. Her oxygen saturation improved upon the initiation of therapy. I don't know how long her treatment lasted, and I'm pretty sure that she was eventually switched over to conventional ventilation. Ultimately, she was discharged without any apparent significant problems, and her mother eventually became a neonatal nurse. There was a TV special done several years ago about this little girl, possibly a TLC program.

It hasn't become a widespread treatment by any means. I suspect that part of the reason for this is that most babies who would benefit from this type of treatment are so very premature as to likely suffer from other significant complications such as IVH, sepsis, etc., making the value of the liquid ventilation treatment questionable.

BittyBabyGrower, MSN, RN · Jul 27, 2004

Are they still even trialing it? I thought the FDA yanked it.

We were just discussing the "Amniotic tank transport isolette" at work yesterday....we have a few, to put it kindly, zygotes in the unit that would have benefited from it. :uhoh3:

Gompers, BSN, RN · Jul 28, 2004

We were just discussing the "Amniotic tank transport isolette" at work yesterday....we have a few, to put it kindly, zygotes in the unit that would have benefited from it.

Yeah, we talk about it sometimes, too. We've all agreed that the day we come to work and are expected to take care of babies floating around in aquariums, it's time to retire!!!

dawngloves, BSN, RN · Jul 29, 2004

But think how easy feeds'll be! Just sprinkle a little Neosure in the top of the tank.....

BittyBabyGrower, MSN, RN · Jul 29, 2004

OMG...LMAO Isn't that the truth LOL Sounds like a Robin Cook novel doesn't it?

VickyRN, MSN, DNP, RN · Jul 29, 2004

Seriously... do you think NICU science will ever evolve to this? Sounds like science fiction now, but so would most of the procedures going on in the NICU today to a nurse 40 years ago. Incredibly, just one generation ago, JFK's infant son (born at 34 weeks' gestation) DIED of RDS because they didn't have ET tubes small enough for babies nor artifical surfactant.

dawngloves, BSN, RN · Jul 29, 2004

I don't doubt it.You are so right. 10 years ago a 24 weeker would have been given comfort care. Who knows what 20 years will bring?

BittyBabyGrower, MSN, RN · Jul 29, 2004

I wouldn't doubt it....19 years ago we didn't save anything less than about 25 weeks and under 500 grams...we just didn't have the technology! We had awful chronics because we didn't have surfactant, we had lots of little horrid CP kids because we didn't know better to regulate BP's, we had lots of little blind babies because we used so much O2, we had lots of NEC kids because their bowels would die from hypoxia. So, yes, we have made many strides...along with maternal strides.

One day, we will have something akin to an artificial womb...and I think that is when I will retire LOL

We just has this talk last night....I know that we have to try with the smaller more immature kids, but we just don't have the technology or equipment available to us right now...until we can figure that out, I really wish we wouldn't torture too many more kids and families....it takes a lot out of a gal!