Preterm Babies : Part 3

by Food and Drug Administration (FDA)

(Page 3 of 3)

Babies on high-frequency ventilators develop other common side effects found with conventional ventilation, such as high blood pressure, a rise in heart rate, brain hemorrhaging, and a condition called pneumothorax, in which air blows out the side of the lungs and into the chest cavity.

"High-frequency ventilation is just not natural, so the body perceives it as something different and reacts to it," says Jim Dillard, a review scientist at FDA. "Over time, more light will be shed on the overall survival improvements with high-frequency ventilators, if any."

At Indiana University's Riley Hospital for Children, where Benjamin and the Carter quadruplets were treated, doctors use high-frequency ventilators in the severest cases.

Two of the Carters' daughters developed more serious lung problems, and one of them, Abigail, was placed on a Bunnell high-frequency ventilator. The other, Katelin, had similar problems but was placed on a conventional ventilator.

"Abigail's lungs healed a lot better and she did a lot better than Katelin did. And their problems were very, very similar," Carter says. "We felt the [high-frequency ventilator] really helped."

"I think it's been moderately successful," says Engle, of the Riley Hospital program. "Babies that would have had less than a 20 percent chance of survival [on conventional ventilation] now have a 50 to 60 percent chance."

Looking for Tomorrow's Cures

In the future, scientists hope to provide even better chances for premature infants like Benjamin and the Carter quadruplets.

Last October, a scientist from The Scripps Research Institute in La Jolla, Calif., described in the journal Science a new kind of surfactant he manufactured with synthetic human proteins. He said the synthetic human surfactant, if successful in humans, could be more like human surfactant than those presently on the market. It has not been tested in humans to show effectiveness and safety, however, one requirement for FDA approval.

According to the National Heart, Lung, and Blood Institute, scientists are examining human surfactant in a number of studies, researching its basic genetic makeup and how it is produced and used by lungs.

In clinical settings, doctors are still testing for the best possible dose and time to give a surfactant to newborns, as well as ways to use the drug to treat adult lung disorders.

For many premature children, new technologies have already eased their untimely transitions from the womb to the world.

The Carter quadruplets, for example, are still not as physically mature as other 2-year-olds, but in other ways they have developed normally. "They're doing just wonderfully," their mother says.

Benjamin McClatchey also is doing well. Now nearly 2 years old, he talks as well as any child his age, even though he, too, is catching up to his peers physically.

"I don't let that get me down," says his mother. "He spent a total of seven months in the hospital out of his first 10 months of life, and a baby can't develop in a hospital bed.

"But he's made a lot of progress since we've had him home. He's doing just great."

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.