Week 7 Jingwei Zhang

This week I spent my time among neonatal ICU, radiology reading room, MRI and CT scanning rooms. In neonatal ICU, I came across several interested cases. First case the patient was a termed baby. Small amount of water got into her lung during water birth. MRI images showed minor abnormalities in her brain, resulted from short term hypoxia. Initially I was not very worried. From my experience adult patients had great chances of full recovery from such small abnormalities. However, Dr. Frayer disagreed. First, baby brain was still growing and developing. It was very unpredictable what the effects would be. From his experience children with part of the brain resected can grow up normally since the brain can use different part to perform the functions of the resected part. On the other hand, damaged brain usually causes more abnormalities. Second, the baby was not following his eyes. Babies were very interested in pairs of big round things, like the eyes and glasses. Normal babies will show interests and follow your eyes as you starring at them. However, she was not responding well to Dr. Frayer. Later, I performed the same exam on her and she was following my eyes nicely. It was a good signs that she was getting better. She was discharged this week.

Another case was a pair of 24 week twins. They had difficulty in breathing because the lungs were not well developed. During pregnancy, most blood bypasses the lung since there is no need to breathe. Nitric oxide was used to dilate pulmonary artery. Elevated oxygen level and neutralize pH at 7.35 also improve gas exchange. At this point they were still not breathing well. There were also skin infections.

             Another common worry was infection. Infections can come from the environment or within the body as bacteria translocate. Urine culture is a common technique to monitor the situation. Specific antibiotic will be used to fight the infections since different bacteria react very differently to each type of antibiotic.

            On the side note, there were three babies discharged this week and another two next week thanks to Dr. Frayer and his medical team. Congratulations! Thank you very much for giving me such great summer immersion experience. Best wishes to you, your medical team, and all the babies in PICU.