Saturday, February 20, 2010

A's and B's

Today is day 65 of NICU life. Issue of the week for little Brynn, A's and B's. Apnea and Bradycardia...

From University of Virginia Health System:
Apnea and bradycardia are two terms a parent of a preemie may become all too familiar with. What exactly are apnea and bradycardia?

Apnea means a period in which breathing stops. In premature babies, apnea is any pause in breathing that lasts longer than 20 seconds, causing bradycardia, or a drop in the baby’s blood oxygen level. Bradycardia means a slowed heart rate. In premature babies, bradycardia is a heart rate of less than 80 beats per minute.

In premature babies, apnea and bradycardia often occur together, along with low blood oxygen levels. First, apnea occurs and the baby will stop breathing. Because the baby isn’t breathing, blood oxygen levels will fall. The heart slows down in response to the low blood oxygen levels. Together, apnea and bradycardia are often called “As and Bs” or"spells", and a low blood oxygen level is often called a desaturation or “desat.”

What Causes Apnea and Bradycardia?
Apnea and bradycardia have many causes in premature babies. Infection, anemia, and problems in the brain can all cause As and Bs. The most common cause of apnea and bradycardia among preemies in the NICU, though, is a condition called apnea of prematurity.

Apnea of prematurity is a condition caused by immature nervous and muscular systems. Apnea of prematurity occurs most frequently in younger preemies; as gestational age decreases, apnea of prematurity increases. Only 7% of babies born at 34 to 35 weeks gestation have apnea of prematurity, but over half of babies born at 30 to 31 weeks suffer from the condition. Apnea can occur because the process in the brain that tells the baby to breathe fails, and the baby stops breathing entirely (central apnea) or because the baby’s immature muscular system isn't strong enough to keep the airway open and airflow is blocked (obstructive apnea). Mixed central and obstructive apnea also occurs.

Here's the deal with A's and B's... When your child is apneic and bradys, you tend to forget to breathe yourself. Typically a child does not pass on a health condition to a parent, but in this case, I think you could fairly say that they do. Almost all the NICU mommas say that they don't breathe too well, either, when their baby is going through a spell.

When I went to the NICU last night, I think my little cupcake decided to show off for me since I went back to work and did not spend the day with her. She had a pretty good a & b episode. She just went stiff and bug-eyed and decided she didn't want to breathe for a bit. Her oxygen saturation went down to 8. Yes that is right, 8% oxygenation. The respiratory therapist had to spend some time bringing her back up with the bag. I often say during these episodes, that I believe I will need to be bagged as well.

"The Spirit of God has made me, and the breath of the Almighty gives me life." Job 33:4

I know that I already posted a little about this last time, but every time it happens, I can't help but be reminded of God's grace and power in our lives. "the breath of the Almighty gives me life" all I can think about when I see that green resuscitation bag is the "breath of the Almighty." That bag is hooked up to oxygen and machines, and etc. but every time I see it, I pray that it will be filled with the breath of the Almighty which will be pushed into her lungs and graciously give my sweet baby girl life. Day after day, I am reminded of the power of God. He continues to sustain her and give her the breath of life. Thank you Jesus, for answering my prayers.

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