One of the major health complications in newborns today is their inability to maintain a stable internal environment within their body ‘Homeostasis’. With the increase in such cases among millions of babies born on a global scale, efforts to find remedies to mitigate the issue are paramount. Nonetheless, this poses some challenges even as researchers agree that some of these processes do yield some positive results. Wiswell (2011) in his article points out that 10% of the world’s newly born babies receive resuscitation.
Resuscitation of newborn infants however poses a risk of damaging their lungs. While a child transforms from fetal life support to the extrauterine, there might be some challenges in the transition due to the complexity of the transformation process. As noted by Wiswell (2011), about 90% of newborns respond positively to the stimulation upon entering the extrauterine livelihood. Nonetheless, the remaining ten percent does not respond positively to stimulation to stabilize the internal body environment.
Hence, they require radical measures to achieve homeostasis. When approaching birth, the fetus has to clear the airways to have internal lung fluid during pregnancy. A few days before delivery, the body automatically reduces the secretion of the lung fluid a process that is fundamental in clearing the infant’s airways. It is during this period when problems begin to arise. Several newborns cannot adequately dry their lungs hence creating a need for inflating their airways and alveoli to allow for the exchange of gas (Wiswell, 2011).
The most affected newborns are those that are born through a cesarean session. The inadequate exchange of oxygen and carbon dioxide causes the lung tissues to collapse and consequently, this affects the entire or some parts of the lungs. Atelectasis is the name given to this condition. Premature infants also remain at a high risk of the same problem to maintain homeostasis (Wiswell, 2012). Lack of a rigid chest wall is the main reason why Actelestasis is rampant in premature infants.
Mostly, premature infants require typical interventions to assist them in this transition. These include the supplemental oxygen as well as the Continuous Positive Airway Pressure also known as the CPAP (Wiswell, 2012). Others include active ventilation, which is through a mask. Although these methods have been tried and yielded success, they nevertheless pose a threat to the lungs the very organ that they should salvage.
Assisted ventilation causes over-distention causing a condition known as Volutrauma. Imbalanced pressure and volume exerted during resuscitation can cause drastic damage to the lungs. The consequences thereof could be inflammation and physical damage to the lungs (Wiswell, 2012). Meconium, which is a stained amniotic fluid, has a toxic influence on the lungs and can lead to disastrous effects on the performance of the lungs.
Cell metabolic functions solely depend on an efficient and adequate oxygen supply to influence growth effectively. Premature infants are more likely to be unable to reach achieve the basic functional residual capacity FRC (Wiswell, 2012). This owes to their surfactant deficient characteristic as pointed out clearly by Wiswell (2012) in his article. To improve and help in lung expansion, the use of CPAPA or PEEP of at least 4-5cm can be helpful. It helps to establish FCR by improving the oxygenation (Wiswell, 2012).
This approach has received a considerable level of endorsement from the medical fraternity. Among the methods used, CPAP stands out as the best although the marginal difference with regard to the rest is not very significant. As mentioned earlier about the pressure and volume required, it is not possible to predetermine an appropriate standard Inspiratory Pressure for all infants (Wiswell, 2012). Reading the article it is clear that newly born infants are in great need of methods to help them establish normal respiration (Wiswell, 2012).
However, the current methods used today in the clinics are not necessarily safe thus cannot standout out as the ideal procedures to perform that lifesaving task. The author has gone ahead and provided information that weighs the credibility of the current methods used and one thing is clear and common to all of them. They work and they are successful but at the same time, they pose a level of danger to the life of the infant and more specifically stressing on the premature newborns.
Preventing such injuries that may occur in the process of trying to save the life of an infant is possible. The author carefully outlines the procedures that are put in place that can mitigate the tragic events that may lead to damaged lung tissues hence, Actelestasis. As the author suggests, the information provided in his article is vital if the situation in the delivery rooms can change in a more positive direction. He laments that currently, our delivery rooms lack the scientific data backup to effect changes that would support lung protection (Wiswell, 2012).
The article is a basis for informed choice when it comes to services in the delivery room especially in support of newborns. The author has brought to the nurses’ attention the predicaments that go alongside child support procedures. This information will help nurses to analyze and take radical measures to increase the chances of an infant achieving homeostasis. For instance, the Surfactant approach used in Europe has gained a lot of publicity and the global world is embracing it.
Suggestions of ways to improve the current therapies as outlined in the article form an ideal basis for research and development. This article is relevant in the nursing profession especially with those who are in the maternity department. The knowledge relayed in this article and the extent of the research undertaken by the author are instrumental in proving the integrity of the information. The article is very informative and provides information useful in the nursing profession and saving and improving lives at the same time.
Many deaths have occurred due to complications in the newborns and their causes are not well defined. However, as the article provides, infant resuscitation can be fatal causing harm to an infant by damaging their lung tissues. In conclusion, it is in every nurse’s best interest to perform and oversee a healthy and successful delivery in the delivery room. Nurses try to make the best of their ability to assist in a safe infant delivery.
This article provides the nurse fraternity with options and solutions to work around the dangers involved in infant resuscitation. The CPAP approach is a good example of the solutions that the author is offering in the article. This article is very relevant to nurses and knowledge is important in the nursing profession.
Wiswell, T., E. (2012). Resuscitation in the Delivery Room: Lung Protection From the First Breath. Respiratory Care. 56 (9),1360-1367.