Puffs of air saved preemie

Ashley and Erik Nadeau of Whitefish never expected that their baby would arrive prematurely and end up fighting for breath.

At birth at North Valley Hospital, little Wyatt sounded vigorous.

“He came out screaming,” Ashley recalled.

Shortly afterward, Nadeau sensed that her obstetrician’s warning to expect respiratory issues was on target as her baby was placed under an oxygen hood.

“From there, things got worse,” she said. “He was grunting for breath.”

Wyatt’s providers at North Valley Hospital soon called for his transport to Kalispell Regional Medical Center’s Neonatal Intensive Care Unit (NICU), where Wyatt was saved by gentle puffs of oxygen from an oscillator infused with nitric oxide from an iNOvent. Both pieces were purchased within the last eight months.

 Wyatt went home June 6 with parents grateful that the hospital had this specialized equipment.

In past years, babies like Wyatt were life-flighted to distant medical centers, forcing parents to leave homes and jobs for months. Even worse, when a preemie goes downhill rapidly like Wyatt, the baby may not survive the trip. 

To remedy those problems, the hospital and its foundation pooled their resources to buy the oscillator and iNOvent, according to Mindy Fuzesy, OB/Nursery manager at Kalispell Regional Medical Center.

She called it life-saving technology.

“It’s very unusual for a facility our size to have this equipment and to have the expertise to take care of babies on this equipment,” she said. “We have a very supportive administration.”

Because it isn’t used every day, Fuzesy said the staff tests and trains on a regular schedule for the moment the hospital’s neonatologist Dr. Judy Rigby decides a baby needs the oscillator’s unique method of ventilating delicate lungs.

For Wyatt, that moment arrived a few days after he was delivered by Dr. Randall Beach at North Valley Hospital. Ashley describes the whole episode —from his early arrival to his spiraling respiratory distress — as a blur.

“I was scared to death,” she said

No one expected any problems with the birth of her first child. Her pregnancy, an exciting and welcome surprise to Ashley and husband Erik, was healthy and uneventful.

As a teacher at East Evergreen Elementary School, she included her first-graders in the excitement of anticipating the baby.

“They were measuring my tummy every day,” she said with a laugh.

On the evening of May 23, her water broke when she was 35 weeks along. Ashley didn’t immediately recognize what was happening until cramping started. She and Erik rushed to North Valley Hospital where, at 9:06 a.m. Monday, Wyatt entered the world with lusty screams and went to the warming table.

“They gave him to me to hold for about three minutes,” she said.

He was a strapping 7 pounds and 19 inches long, but size doesn’t guarantee escape from respiratory problems for those born even a few weeks early. Wyatt was diagnosed with pulmonary hypertension, a condition in which high blood pressure in the arteries supplying the lungs reduces oxygen available to the rest of the body.

“They gave him some time to see if he would come around,” she said.

By 2 p.m. Monday afternoon, a transport team arrived from Kalispell Regional Medical Center to stabilize and then transport the baby to their NICU.

Both Wyatt and Ashley were readmitted to the OB department by 3 p.m. Monday, where Wyatt started with a continuous positive air pressure machine and then a conventional ventilator. He did well Tuesday, but then took a turn for the worse.

“They switched him to the oscillator to open up the air sacs and give him puffs of air,” Ashley said.

The OB/nursery manager Fuzesy described the operation as bouncing air into the lungs at the rate of 600 puffs per minute, never allowing them to deflate. It uses less pressure than a conventional ventilator, reducing potential damage to fragile lung tissue and long-term chronic lung disease.

Ashley recalled watching her son’s chest vibrate as he received the oscillator puffs.

“He looked like he was panting like a puppy dog,” she said.

To make the oscillator more effective, the iNOvent adds a precise dose of nitric oxide into the oxygen mix. Fuzesy said the gas relaxes the blood vessels and pressure in the lungs, allowing the oxygen to work better.

She stressed that only a select group of babies requires the specialized equipment. Wyatt was the third baby to benefit from the oscillator purchased last fall and the first to receive nitric oxide supplied by the iNOvent obtained in December.

Since opening the NICU in February 2008, the daily census of little patients has exceeded projections, including some very sick babies like Wyatt.

“He took pretty much every piece of equipment we have,” she said.

The neonatologist remained at or near Wyatt’s bedside for most of the 92 hours that he remained on the oscillator. Fuzesy said Rigby went home once in the first 48 hours to feed her dogs.

“I’ve never seen dedication like hers,” she said.

Ashley agreed, calling Rigby wonderful and the nursing and other staff “very loving and caring.” She was also grateful for the expertise and quick action of the staff at North Valley Hospital in moving Wyatt to the NICU at Kalispell Regional Hospital.

She was able to watch her son heal as a “boarder” mom living at the hospital. Ashley said that Wyatt gave signs that he knew she and his dad were near.

“He’d stir when he heard our voices,” she said. “Even though we live 15 minutes away, I could not have imagined having to leave my little baby.”

Wyatt got better each day until he was finally weaned from the machines and Ashley got to hold him for the first time since those three minutes after his birth. After two weeks in the NICU, he was healthy enough to get discharged just days before Ashley’s 29th birthday.

“We took him home and he’s doing wonderfully,” she said. “You’d never know that he went through all of this.”

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.