Inside the hospital unit treating B.C.’s most at-risk infants

B.C. Women’s Hospital is giving an inside look at the team and technology it’s using to give the province’s most vulnerable babies their best fighting chance.

The hospital’s neonatal intensive care unit (NICU) sees about 1,000 tiny patients every year — patients like four-month-old baby Arjan.

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The infant was born with pulmonary hypertension, and his heart and lungs have struggled to meet the needs of his growing body.

One of the only ways to know what’s going on inside his body is assessment with a specialized ultrasound tool.

Neonatologist Dr. Souvik Mitra is one of just two doctors at the hospital trained to use the TnECHO technology at the hospital.

The highly sensitive device can help pinpoint defects in the smallest of blood vessels, and help tailor treatment for patients.

“It is a fine balance between when to treat and when not to treat, because every treatment comes with its own risks as well,” Mitra explained.

Mitra said the hope is to train more physicians with the tool, boosting the number of specialists who can work alongside pediatric cardiologists in the province to tailor precision care for high-risk infants.

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More machines and more doctors, he said, can save more lives.

“Five, 10 years back, … you would have less information about what is actually happening with the heart, and how the heart and lungs are interacting,” he said.

“So we would provide our care just based on what we are seeing, and what our bloodwork looks like and how he responds to the ventilation. Now we have better information about what actually is going on with the heart.”

The technology comes as advances in maternal medicine push premature delivery rates higher than they have ever been.

Despite more complex cases, discharge rates have also risen, with more infants going home healthy.

“A lot of it is the increased advances in newborn care, and also the dedicated care that’s provide by our team here in B.C. Women’s Hospital NICU,” neonatologist Dr. Emily Kieran said.

Baby Arjan isn’t out of the woods yet: he has a hernia surgery scheduled for the new year.

But Mitra said it’s a far cry from his condition when he was admitted, hooked up to multiple lines and tubes, on ventilation and multiple medications.

“The next big thing for him is to work on feeding by mouth,” he said. “And then off he goes to his home.”