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1 year back, a newborn with Meconium aspiration & persistent respiratory distress, and severe PPHN (Increased pressure of Blood vessels of lungs) was referred to Orange Neonatal & Pediatric Intensive Care Unit for further management. At that time, we put the baby on HFO, on inotrops via central line & tried level best with all available facilities to make him survive! But as the child started deteriorating, we needed INO (The ultimate drug of choice for treatment of PPHN), But due to the lack of availability of the same at our unit, we decided to timely refer the child to another NICU. In Ahmedabad! That baby survived after a long battle and went home!
Cut to the present day!
1 week back, we received a similar kind of newborn baby with a similar disease late at night! The child was put on a conventional ventilator with required inotropes in a central line. However, the child started deteriorating with raising the Oxygenation Index on 100% oxygen, so we put him on High-frequency Ventilator. 2D echo showed severe PPHN (no cardiac anomalies). Even after multidisciplinary management of PPHN child started deteriorating at 3 am. This was the time when we decided to put the child on INO. Yes! We had it (INO) at the right time at the right place this time! This is Gujarat’s 1st GeaNOX inhaled Nitric Oxide system -1st of its kind in Gujarat! Yes, this was installed on the very next month at Orange Neonatal and Pediatric ICU when the 1st child needed to be referred to another hospital.
It’s almost a dictum in neonatologists across the globe that if Nitric can’t save, no one can save! This baby as well responded magically to iNO therapy. After a fierce fight of 5 days, the child was extubated to room air and went home on “Bhaidooj.”
This is the magic that happens when a well-equipped NICU meets an equally resounding team of Neonatologists (even in the time of Diwali /New Year)
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