Respiratory Assistance

Premature and critically ill newborns often have respiratory problems. The Children’s Hospital at Saint Peter’s offers the most advanced technologies to treat them. Our doctors use several lifesaving treatments for newborns. The Neonatal Intensive Care Unit (NICU) at Saint Peter’s was one of the first hospitals in New Jersey to evaluate the use of surfactant therapy, which is now routinely used to treat breathing problems in premature babies. Our NICU also uses state-of-the art technology such as:

• High frequency jet ventilation, and high frequency oscillators which help babies breathe without stressing the lungs.
• Nitric oxide therapy used for treatment of hypoxic respiratory failure
• NAVA (Neurally Adjusted Ventilator Assist), a new mode of assisted mechanical ventilation in which the ventilator is triggered by changes in the electrical activity of the diaphragm. With this new technology newborns are able to wean their own ventilator support in response to improving respiratory compliance. While on NAVA newborns control the amount of ventilator assistance needed  to ventilate effectively as a result this will reduce the risk of damage to the lungs as well as reduce the risk of chronic lung injury from a prolong mechanical  support.

Hypothermia Program

Neonatologists have witnessed tremendous advances in medicine’s ability to save the lives of critically ill newborns. But until recently there was simply no treatment available to stop the damage caused by asphyxia or lack of oxygen to the brain.Now a new technique is giving newborns another chance at living a more normal life: brain cooling. The Neonatal Intensive Care (NICU) at The Children’s Hospital at Saint Peter’s University Hospital became one of the first in the region to offer this procedure in 2011.

Reducing body temperature is already used during certain neurological and heart procedures for adults. Now, two new international studies have demonstrated the value of cooling the brain in newborns suffering with moderate or severe asphyxia.

Technically called hypoxic-ischemic encephalopathy, or HIE, the condition evolves over several hours. The initial lack of oxygen and blood supply to the brain kicks off a series of other events as the body tries to repair itself. The natural approach is effective when HIE is mild, but in moderate to severe cases, the body’s natural attempts could cause more brain damage.

All too often, the result is long term developmental, physical and mental delays. Many infants with HIE will face life-long struggles with cerebral palsy, mental retardation, learning disabilities and vision or hearing impairments. Up to 60 percent of all newborns with HIE die. The cooling technique is designed to minimize such outcomes. Using specialized equipment adapted to newborns, neonatologists reduce the baby’s core body temperature over a period of 72 hours. Studies report a 16 to 27 percent drop in the number of deaths or severe disability.

Timing however is critical. In order for this to work, brain cooling must be initiated with in six hours of delivery in infants with asphyxia. Asphyxia occurs both before and during birth. Any baby who is at risk of, or suspected of suffering moderate or severe asphyxia should be considered for immediate transfer to the NICU at Saint Peter’s for evaluation.

Brain Cooling Criteria:

The baby must be at least 36 weeks gestation and must meet at least one of the following criteria:

● Apgar score ≤ 5 at 10 minutes

● Continued need for resuscitation including intubation or mask ventilation at 10 minutes of life

● Acidosis defined as pH ≤7.00 within 60 minutes of birth.

(For location/contact information: Phone: 732- 937-6048 (direct line to the NICU).