【体外膜肺ECMO精品课件】 FOLLOW UP OF THE NICU GRADUATE.ppt

* * * * * * * * * * * * * * * * * * * * HOME OXYGEN USE Will need concurrent care with Pulmonology to help with discontinuing oxygen CASE PRESENTATION-C.W. C.W. is a 24 WGA male who was admitted to the NICU for prematurity and resp distress. He presents to Developmental Clinic 3 mos after D/C. What are some things you want to know? Maternal labs were negative, but mother presented with preterm labor. Nearly 1 year hospital course notable for multiple complications particularly Grade IV bilateral IVH Pt discharged home on O2 with seizure medications and close neurosurgery follow-up. C.W. (CONT.) The mother wants to know if it is ok that her baby is not walking as he is now 13 mos old. Thoughts? Consider pt’s corrected age Majority will correct by 1 year of age However, correction for developmental milestones may be continued until 2 years of age. What are the risk factors for abnormal development? EARLY INTERVENTIONS Candidates: High risk infant Neurologic condition IVH PVL Seizures Visual impairment Hearing loss At risk infant BW 1200g GA 32 weeks Total hospital stay 25d APGARS 5 at 5 min IUGR SGA The high risk infant and the at risk infant have the potential for abnormal outcomes…normal HUS does not guarantee normal outcome, nor does abnormal HUS guarantee abnormal outcome. Helping parents understand and cope with this (must be patient) is one of the challenges we face. EARLY INTERVENTION Can be accomplished through Developmental clinic School based intervention Early Steps via parish Multidisciplinary care Neurology PT/OT/Speech Psychology CASE PRESENTATION-S.W. S.W. is a 27 WGA male that was admitted to the NICU for prematurity and resp distress. On initial D/C follow up, infant was noted to be gaining weight and doing well. What are some things you want to know? Maternal labs were negative, but mother presented with placental abruption. 2.5 month hospital course Short intubation period Prolonged use of supplemental O2 via HFNC Stage 2 Zon