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Journey to Africa: Saving the lives of young ones

BY RITA T. WADHWANI

This past June, I traveled with Uday Devaskar, the director of neonatology at UCLA’s Mattel Children’s Hospital, and neonatology fellow Heather Cahan to Pune, India, to introduce a new lifesaving technology to the neonatal intensive care units at two hospitals in the region.

The technology, a High Frequency Ventilator (Hi Fi), also known as the Oscillator, could potentially save the lives of many stricken infants. The Oscillator has been in routine use since the 1980s in the West, saving the lives of babies with premature lungs who might otherwise have died using the conventional respirator. (Conventional respirators are generally effective, but not always successful in getting oxygen in and removing the carbon dioxide.) However, Oscillators have not yet been introduced in developing countries.

At one of the hospitals, we were presented with a baby boy weighing less than 2.5 pounds. Despite receiving 100% oxygen by a conventional ventilator that forced oxygen into the alveoli of his lungs, his blood oxygen level was dangerously low. After reviewing his case, we decided the Oscillator could help this baby.

As we prepared the child, about 25 physicians, nurses, residents, medical students and administrators gathered to witness the historic event. Emotions were mixed; anxiety, curiosity, apprehension, excitement and skepticism were evident.

Once everything was prepared, we discontinued the conventional respirator and switched to the new machine. For the first time in India, a baby was assisted by the Hi Fi ventilator. To our surprise, the assembled hospital staff gave out a loud applause. Within minutes, the baby’s oxygen level improved and smiles of sweet success from eager Indian physicians and nurses emerged. There was significant improvement by many standards. The day went by quickly and, before we knew it, it was late night.

Though the baby’s respiratory condition improved considerably with the use of the Hi Fi respirator, he subsequently died due to other complications unrelated to the respiratory system.

Everyone was disheartened, and some were skeptical about the technology. Nonetheless, we returned to Los Angeles with a great sense of accomplishment. Since our visit in June, nine babies at King Edward Memorial Hospital have been treated with Hi Fi; four died and five went home successfully.

These positive results validated our efforts and gave us a great sense of satisfaction. It was worth flying across seven oceans to Pune after all. We feel confident that physicians and nurses at the hospitals we visited will continue to save the lives of these most tiny patients.

There have been many other consequences from these visits. The nurses have a greater sense of autonomy and empowerment in their personal and professional lives. The physicians have a greater educative and technological control over the outcomes of their patients.

Plans are already under way for introduction of yet another technology next summer. That is another story.

Wadhwani is a neonatology nurse at UCLA’s Mattel Children’s Hospital.