Background:
A preterm infant (born at 28 weeks of gestation), weighing 1.2 kg, was admitted to the NICU with respiratory distress, low birth weight, and underdeveloped organ systems. The baby was delivered via emergency cesarean section due to maternal preeclampsia.
Initial Assessment:
- Symptoms: Labored breathing, cyanosis, low APGAR score (5 at 1 minute, 7 at 5 minutes).
- Diagnosis: Respiratory Distress Syndrome (RDS), Hypothermia, and Hypoglycemia.
- Interventions Initiated:
- Immediate placement in a temperature-controlled incubator.
- Administration of surfactant therapy for RDS.
- Oxygen therapy with nasal Continuous Positive Airway Pressure (nCPAP).
- Intravenous fluids and glucose to manage hypoglycemia.
Management Plan:
- Respiratory Support:
- Frequent monitoring of oxygen saturation and blood gas levels.
- Gradual weaning from oxygen support as lung function improved.
- Nutritional Support:
- Initiation of total parenteral nutrition (TPN) in the first 24 hours.
- Transition to expressed breast milk through a nasogastric tube once the baby showed feeding readiness.
- Infection Prevention:
- Strict aseptic protocols to reduce the risk of sepsis.
- Prophylactic antibiotics administered based on blood culture results.
- Growth and Development Monitoring:
- Daily weight checks and monitoring of vital signs.
- Regular cranial ultrasounds to rule out intraventricular hemorrhage (IVH).
Outcome:
Over the next six weeks:
- Respiratory function stabilized, and the baby was weaned off oxygen.
- Weight increased steadily to 2.5 kg.
- Successful transition from tube feeding to oral breastfeeding.
- No signs of infection or major complications.
Discharge Plan:
- Home care education provided to parents, including feeding techniques and hygiene practices.
- Scheduled follow-ups for growth monitoring, vaccinations, and developmental assessments.
Conclusion:
This case highlights the importance of early intervention, multidisciplinary teamwork, and advanced NICU care in managing high-risk preterm infants. Through comprehensive care, the infant achieved significant milestones, ensuring a healthy start to life.