Babies and infants admitted to Butterfly - Newborn Intensive
Care have a wide range of complex medical and surgical problems.
These include severe respiratory failure particularly that
associated with:
- Cystic chronic lung disease and/or pulmonary
hypertension,
- Congenital diaphragmatic hernia
- Tracheo-oesophageal fistula and oesophageal
atresia,
- Pierre Robin
Sequence
- Gastroschisis and exomphalos
- Necrotising enterocolitis
- Premature babies with cardiac anomalies
- Hypoxic ischaemiac encephalopathy
- Complex seizure disorders
- Bronchiolitis
- Meningitis
- Complex genetic and metabolic conditions
Our team
The management of our babies is overseen by a team of
neonatologists, neonatal nurses and Allied Health specialists. The
care of many of our babies also involves extensive cooperation with
RCH surgical teams including:
Sub-specialist paediatric teams are also involved,
including:
Particularly complex and/or long term patients are appointed a
care manager to coordinate their care.
Many of the babies in Butterfly - Newborn Intensive Care make
use of the range of diagnostic services provided by the RCH. These
include MRI, CT, digital angiography, fluoroscopy, endoscopy,
bronchoscopy, laryngoscopy, electro-encephalography,
echocardiography, complex metabolic and laboratory tests and
cardiac catheterisation, many of which are unavailable at other
hospitals.
Respiratory support
Butterfly - Newborn Intensive Care has the capacity to ventilate
up to 14 babies. High Frequency Oscillatory Ventilation (HFOV) is a
highly sophisticated form of artificial ventilation in which very
sick babies are ventilated at rates of up to 900 breaths per
minute.
We were the first neonatal intensive care unit in Australia to
introduce this technology in 1992; the result of a careful and
strategic research and training programme. We now hold an annual
training course for other HFOV users in Australia and New
Zealand.
We were the first neonatal intensive care unit in the country to
use High Frequency Jet Ventilation (HFJV). This technology can be
life saving for babies with the more severe forms of lung disease
such as severe congenital diaphragmatic hernia, cystic chronic lung
disease and other conditions with significant gas trapping.
Vein of Galen Malformation
Together with our interventional radiology colleagues at The
Royal Melbourne Hospital we have led the way in the management of a
rare form of cerebral aneurysm called Vein of Galen Malformation.
Thus we have been able to improve survival and neuro-developmental
outcomes to many babies who would otherwise have died or suffered
severe brain injury.
Mandibular Distraction
Our maxillofacial surgeons are performing jaw lengthening
operations (mandibular distraction) for babies born with airway obstruction
due to a small jaw (Pierre Robin Sequence). This surgery has
produced stunningly successful outcomes and revolutionised the care
of this condition. In Australia this operation is performed only at
The Royal Children's Hospital.
Neurology and the neonate
Together with our Neurology colleagues, we are developing and
investigating the role of advanced MRI techniques in the management
of our sickest babies. Our understanding of MRI findings allows us
to better predict neuro-developmental outcome in congenital brain
abnormalities and acquired brain injury.
We are also using amplitude-integrated Electro-Encephalography
(EEG) as an assessment tool in patients with suspected seizures and
as a research tool.
Pain
Our nursing staff have pioneered research into the prevention
and management of pain in babies; and have developed tools (Pain
Assessment Tool) and interventions which are now being used in many
other hospitals.
Specialist clinics
Once discharged from Butterfly - Newborn Intensive Care, babies
are followed up by either their general practitioner, paediatrician
or neonatologist. RCH neonatologists see their patients in
the RCH
Specialist Clinics (Outpatients), and appointments are arranged
prior to discharge.