Author: admin_pms

Neobreathe—Treat Asphyxia with Ease

 Millions of neonatal deaths arise due to asphyxia. There are different reasons why newborn babies just cannot start breathing by themselves. Some babies are born with the lungs insufficiently developed. Others have fluid in the windpipe, having swallowed meconium in the womb. And there are babies who simply need an initial gasp of air to start breathing. These newborns can be saved using a simple life-saving procedure called resuscitation. Across the world, people are provided the basic equipment (essentially a bag and mask that pumps air) that is required for resuscitation, and they are trained to use this equipment. Unfortunately, there is still a lack of skilled people and of resuscitation devices, and so it is difficult to save babies in a lot of places.

Basic resuscitation care

A general resuscitation procedure is carried out immediately after the birth of a baby. Indeed, this must be done during the first 60 seconds after the birth of the infant, this period being referred to as the golden minute.

During resuscitation, first any fluid that may be present in the windpipe is removed, by suction. Then artificial breaths are given using the bag–mask. Cardiac massage is performed if necessary. Typically, two staff members are involved in carrying out resuscitation. One performs the actual resuscitation. It is important to note that this staff member must use both hands. He or she uses one hand to generate pressure with the bag; the other hand holds the mask to the baby’s face, preventing air from leaking where the mask touches the face. The other care-giver applies suction and gives the cardiac massage.

Neobreathe

Phoenix has come up with a cost-effective, innovative resuscitation product called Neobreathe. Phoenix designed the device along with Stanford Biodesign and commercialize Neobreathe.

Neobreathe is designed such that the operator needs to use only one hand—to hold the mask to the face. To generate the pressure, the operator uses his or her foot—Neobreathe is the world’s first foot-operated newborn resuscitation system. Neobreathe also has an integrated suction unit.

Neobreathe’s single-handed operation feature permits one hand of the user free for chest compression or CPR. This feature is most useful in places where there is a shortage of skilled labour. The device also gives the user the liberty to use both hands to seal the mask effectively. A study conducted by the inventor Dr. Avijit Bansal shows that face mask leakage can be reduced to a good extent when the mask is sealed well.

Neobreathe is a user-friendly device requiring minimal training compared with the traditional bag and mask. It is fitted with a manometer that displays the pressure delivered so that the clinician can monitor it while he or she observes the chest rise. Neobreathe is also provided with a pressure safety valve.

Actually Neobreathe has several other features. For instance, the oxygen level in the air delivered by the device can be regulated over a broad range. Another feature is a PEEP valve. This valve permits the peak end expiratory pressure (PEEP) to be maintained at a set value so that the lungs of babies with difficulties do not collapse.

Neobreathe fits conveniently into labour rooms, NICUs, paediatric centres and public health care centres. Its cost-effectiveness and innovative features make it very suitable and affordable for all users.

To know more about Neobreathe, please visit the product page:

https://www.phoenixmedicalsystems.com/infant-care/respiratory/neobreathe/

Perinatal asphyxia – Brain injury at birth 

Perinatal asphyxia, also known as hypoxic-ischemic encephalopathy (HIE), causes acute or subacute brain injury due to asphyxia.
Earlier, no significant treatment was available for HIE. Later with research evidences, they found cooling baby’s brain reduces the metabolic rate of cells, in turn reducing brain damage. This can be achieved if treatment begins within 6 hours of birth.

Qualification of baby for hypothermia treatment:
Any term baby suffering from perinatal asphyxia with qualified APGAR score are eligible for hypothermia treatment.
Apart from this, various tests and symptoms indicate baby might have HIE.

• Meconium-stained amniotic fluid
• Low heart rate
• Poor muscle tone
• Weak breathing or no breathing at all
• Bluish or pale skin color
• Excessive acid in the blood

Also CT scan, MRI scan, echocardiography, and ultrasound are taken for confirmation. Optional tests may include electrocardiogram (EKG), electroencephalogram (EEG).

 Treatment:
Immediate treatment for infants born with HIE involves cooling the baby for three days. Few degree drop in temperature result in significant less brain injury.
The baby will be placed on a cooling blanket for three days and are closely monitored for any signs of discomfort.

The treatment usually involves head cooling or total body cooling. Initially they started with head cooling, down the line they concluded the deeper parts of brain didn’t receive proper cooling leading to brain damage. Later they discovered, whole body cooling is much effective compared to selective head cooling.

Monitoring during treatment:
While baby is under treatment, baby is constantly monitored.
They check heart rate, breathing pattern, temperature along with monitoring of brain activity with EEG and with cerebral function monitor (CFM).

During the cooling period, it is normal for your baby to have a slower heart rate and breathing rate, and to appear quiet and sleepy. Baby will receive nutrition through intravenous (IV) therapy.

Treatment cycle:
1) Rapid cooling – cool the baby to 33.5 ˚ – 34.5˚ from 37.5˚.
2) Constant temperature phase – maintain the temperature for 72 hours
3) Slow re -warming: Increase baby temperate by 0.1˚ to 0.2˚ per hour till it reaches 37˚.
4) Monitor the baby for next 24 hours for thermal maintainence.

Introducing Brammi..

We are gratified to see how well clinicians are taking efforts to save these precious lives. Contributing to HIE therapy, Phoenix came up with ingenious servo controlled cooling system – “Brammi”. The unit is designed in such a way complete treatment cycle is taken care. The system maintains 33.5˚ for 72 hours and immediately starts rewarming at pace of 0.1˚ to 0.5˚
Brammi’s intuitive feature helps to closely monitor baby with graphical representation of data and comes with safety parameters. The patient data along with name can be ported out through USB. Understanding the treatment has to start within 6 hours of birth, the unit is built light weight (portable) with 3 hour battery back up for easy transportation. Cool the baby, anytime – anywhere.

For more information on Brammi please contact any phoenix representative.
Source : ncbi.

HIE (Hypoxic Ischemic Encephalopathy ) is one of the leading causes of Neonatal death.
Every year roughly 10 to 60% babies with HIE die in new born period. Atleast 25% of HIE babies receiving delayed treatment suffer neuro developmental issues. 

What is HIE?
HIE stands for Hypoxic Ischemic Encephalopathy

HIE occurs because the baby lacked oxygen or blood flow around time of birth. Eventually, causing brain injury and can result in cerebral palsy and other cognitive and developmental impairments.
Several scientific studies have proven decreasing the body temperature reduces neuro damage.

HIE therapy :
Hypothermia therapy is usually carried out with a cooling system.Therapy usually begins within 6 hours of birth and lasts for next 72 hours. The therapy phase maintains few degree less than body temperature. This phase slows down the metabolic rate of cells. The baby is monitored in therapy phase until treatment stabilizes brain cells preventing further damage. Finally baby’s normal body temperature is slowly regained in 6-7 hours of span.

Stay tune for next post on HIE.