Ongoing care of breathing problemsOOngoing care of breathing problemsOngoing care of breathing problemsEnglishRespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemHealthy living and preventionPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC12.000000000000042.00000000000001094.00000000000Flat ContentHealth A-Z<p>Read about ongoing care options for a premature baby's breathing problems. CLD, supplemental oxygen, and ventilation are discussed.</p><p>The first thing that parents can do before bringing home a premature baby who has had lung complications in the NICU, is to clean the house and remove air pollution sources. Potential allergens should be removed and smoking should not be allowed in the house. Depending on the circumstances, parents may also want to consider not having a pet. </p><h2>Key points</h2> <ul><li>Chronic lung disease (CLD) is the most common reason for re-hospitalization during the first year of a premature baby’s life.</li> <li>Signs of respiratory distress include indrawing, increased respirations, nostril flaring, and a change in baby's colour or level of awareness.</li> <li>If a baby is sent home with supplemental oxygen or specific medications, parents must learn how to properly use them.</li></ul>
Soins continus des problèmes respiratoiresSSoins continus des problèmes respiratoiresOngoing care of breathing problemsFrenchRespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemHealthy living and preventionPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC12.000000000000042.00000000000001094.00000000000Flat ContentHealth A-Z<p>Lisez au sujet des options de soins continus pour les problèmes respiratoires du bébé prématuré. La maladie pulmonaire chronique, l’oxygène d’appoint, et la ventilation y sont présentés.</p><p>La première chose que les parents peuvent faire avant d’amener à la maison leur bébé prématuré qui a subi des problèmes respiratoires à l’unité néonatale des soins intensifs (UNSI), est de nettoyer la maison et d’enlever les sources de pollution de l’air. Les allergènes potentiels devraient être éliminés et il devrait être interdit de fumer dans la maison. Selon les circonstances, les parents peuvent aussi envisager de ne pas avoir d’animaux domestiques.</p><h2>À retenir</h2> <ul><li>La maladie pulmonaire chronique est la cause la plus courante de réadmission à l’hôpital au cours de la première année d’un bébé prématuré.</li> <li>Les symptômes de détresse respiratoire comprennent la rétraction de la paroi thoracique lors des inspirations, la respiration accélérée, le battement des ailes du nez et un changement dans la couleur du bébé ou de son niveau de conscience.</li> <li>Si le bébé obtient son congé de l’hôpital accompagné d’oxygène d’appoint ou de médicaments spécifiques, les parents devront apprendre à bien s’en servir.</li></ul>

 

 

Ongoing care of breathing problems1862.00000000000Ongoing care of breathing problemsOngoing care of breathing problemsOEnglishRespiratoryPremature;Newborn (0-28 days);Baby (1-12 months)LungsRespiratory systemHealthy living and preventionPrenatal Adult (19+)NA2009-10-31T04:00:00ZAndrew James, MBChB, MBI, FRACP, FRCPC12.000000000000042.00000000000001094.00000000000Flat ContentHealth A-Z<p>Read about ongoing care options for a premature baby's breathing problems. CLD, supplemental oxygen, and ventilation are discussed.</p><p>The first thing that parents can do before bringing home a premature baby who has had lung complications in the NICU, is to clean the house and remove air pollution sources. Potential allergens should be removed and smoking should not be allowed in the house. Depending on the circumstances, parents may also want to consider not having a pet. </p><h2>Key points</h2> <ul><li>Chronic lung disease (CLD) is the most common reason for re-hospitalization during the first year of a premature baby’s life.</li> <li>Signs of respiratory distress include indrawing, increased respirations, nostril flaring, and a change in baby's colour or level of awareness.</li> <li>If a baby is sent home with supplemental oxygen or specific medications, parents must learn how to properly use them.</li></ul><h2>Ongoing care of chronic lung disease</h2><p>Chronic lung disease (CLD) is the most common reason for re-hospitalization during the first year of a premature baby’s life. Babies who have had lung conditions and needed mechanical ventilation in the NICU will need follow-up care, preferably at a lung clinic if one exists in the area. In the least, parents should have all the baby’s medical documents including X-rays and try to find a paediatrician to provide medical care after discharge. Usually, it is best that one health care professional does the follow-up. That professional will have a more detailed understanding of the baby and their condition, making it less likely that an assessment such as an X-ray or a lung function test will be misinterpreted. </p><h3>CLD and infection</h3><p>Although all babies are at risk, premature babies who have CLD are at higher risk for common lung infections in infancy. Several things can be done to reduce the risk. First, parents may wish to take steps to lower the chances that the baby will be exposed to an infectious agent. This might involve restricting visitors to the home especially during the winter months when viral infections are common. Second, parents should make sure that the baby is immunized against whooping cough, diphtheria, and other serious infections.</p><p>Respiratory syncytial virus (RSV) is a common respiratory tract infection in all age groups. The infection occurs most often and is most severe in young babies aged three to six months. Babies with weakened lungs are more at risk for severe effects of the virus. Nearly 60% of babies are infected in the first year of life. </p><p>RSV protection is recommended for all high-risk babies during the winter months. Babies considered at high risk for RSV infection include premature babies born before 35 weeks of pregnancy and babies with a major congenital heart condition. Passive immunization with an antibody against RSV is injected intramuscularly every month during the winter season. A drug called <a href="/Article?contentid=208&language=English">palivizumab​</a> is the current approach to preventing RSV infection. </p><h2>Ventilation and supplemental oxygen</h2> <p>Babies rarely go home while still requiring ventilation. However, some premature babies will go home with supplemental oxygen. Supplemental oxygen is delivered through nasal prongs and simply increases the amount of oxygen in the air that a baby breaths without interfering with the baby’s spontaneous breaths.</p><p>If a baby is going home with supplemental oxygen, parents will have to learn how to use the equipment. They will have to prepare for it to be available at all times, starting with the baby’s initial arrival at the family home. Additionally, parents will have to consider how the equipment and service will be paid for. A discharge nurse or staff at the lung clinic should be able to help out. </p><p>It is not difficult to learn how to use supplemental oxygen, however, it does take some effort. Additionally, babies on supplemental oxygen will likely need some form of home care. This, coupled with the need to have people come by to replace oxygen tanks and perhaps service the machine, means there will be less privacy for the family. </p><p>Babies using supplemental oxygen are also monitored to ensure that the oxygen levels in the body remains appropriate. This is usually accomplished with pulse oximetry, a small, non invasive monitor that is attached to a baby’s finger or toe. A light shines through the finger and measures the amount of oxygen in the blood. An alarm goes off if the oxygen level falls below the desired level. </p><p>Oxygen in concentrated amounts is potentially dangerous and open flames in the house should be avoided.</p><p>Generally speaking, babies are slowly weaned off supplemental oxygen. This process can take a few months, to the best part of a year or sometimes even longer. At follow up-visits, health care providers will slowly decrease the amount flow of oxygen while monitoring the baby’s oxygen level in the body, and see what happens. As time goes by, babies will be able to go longer and longer periods without supplemental oxygen until they reach a point where they no longer need it at all. </p><h2>When to worry about breathing problems</h2><p>Parents of premature babies with weakened lungs should learn the signs of respiratory distress. Usually, these include:</p><ul><li>indrawing, which is a retraction of the skin between the ribs or over the windpipe during breathing </li><li>increased respirations </li><li>nostril flaring </li><li>change in baby’s colour or level of awareness </li></ul><p>Respiratory distress is an emergency and requires immediate medical attention. Respiratory distress can occur as a result of common respiratory infections. </p><h2>Apnea</h2><p>Apnea, or a brief pause in breathing, is common and is often not a concern. However, if a baby suffers apnea associated with changes in colour, parents should seek medical attention. Home apnea monitors are available; however, their utility in decreasing the risk of the life threatening consequences of apnea is still in question. Therefore, home apnea monitors are not routinely recommended. </p><p>Apnea can occur because of mixed signals from the brain, which is called central apnea, or it may be caused by an obstruction. If a baby is trying to breath but air is not reaching the lungs, this is probably a sign of an obstruction which must be removed immediately. Additionally, if a baby is taking quick shallow breaths, this may be a sign of obstruction since this behaviour compensates for a lack of oxygen reaching the lungs. </p><h2>Medication</h2><p>Some premature babies may be prescribed inhaled medications such as Ventolin (albuterol or <a href="/Article?contentid=234&language=English">salbutamol​</a>) or steroids, which must continue as a treatment when the baby goes home. Parents must learn how to use a baby inhaler and make sure that the supply of the inhaled medications is maintained. These inhaled medications work to reduce inflammation of the lung tissues and dilate the airways and therefore improve breathing. Because a baby is undergoing this type of treatment, it does not mean that they will have to continue on the inhalers for the rest of their life. Most children eventually become healthy enough that they no longer require the inhaled medications. </p><h4>More information</h4><ul><li> <a href="/Article?contentid=1763&language=English">Breathing </a></li><li> <a href="/Article?contentid=1795&language=English">Diagnosis of Breathing Problems </a></li><li> <a href="/Article?contentid=1835&language=English">Treatment of Breathing Problems </a></li></ul>Ongoing care of breathing problems

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