Gaining Time for Little Lungs to Mature (2008)


Charlene Bronson had done everything her doctors told her to, but her baby still arrived a month early.

Johnny's lungs had needed more time to grow, and he quickly developed severe respiratory failure that left him struggling to breathe. 

Doctors at the local hospital responded quickly. When the settings on his ventilator were as high as they could go and Johnny still failed to respond, they called Emory-Children's Center medical director Lucky Jain (pictured right), an expert in lung problems often seen in late preterm infants.

Johnny was transported to Children’s Healthcare of Atlanta at Egleston by Angel II, an ambulance service for high-risk infants and pregnant women, which is based at Grady Hospital, funded by the state, and operated by the Emory Regional Perinatal Center. Once at Children's, the infant was quickly readied for extracorporeal membrane oxygenation or ECMO.

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Gaining Times for Little Lungs to Mature

Johnny's frightened mother winced at the sight of her son's blood circulating outside his body in a swirl and tangle of clear plastic tubes. In the tubes leading away from his body, the blood was dark purple. The tubes leading from the artificial lung and back to Johnny were valentine red, almost glowing with the oxygen molecules his body needed so badly. Twenty years ago, babies like Johnny often died before their lungs could mature. A week after he arrived at Children's, Johnny was breathing on his own and beginning to take nutrients with a feeding tube.

It's wonderful to have this kind of technology, says Jain—and wonderful to be part of two institutions, the Emory-Children's Center and Children's Healthcare of Atlanta, where the technology is available to children regardless of their ability to pay. Johnny's mother and her husband work, but they qualified for Medicaid, which paid a little more than $3,000 of the almost $18,000 worth of physician services provided. Emory covered the rest, just as Children's covered the unreimbursed costs of hospital services.

Emory expects to continue to subsidize Johnny's care in an effort to have the best long-term outcome possible. Based on early brain scans and neurologic exams, doctors believe the infant is likely to have a complete recovery, but just to be sure he already is enrolled in a special long-term neurologic and developmental follow-up program, run by the Emory Regional Perinatal Center for infants identified to be at risk. Over the next several years, this program will track Johnny's development and, if necessary, provide early intervention and therapy. How much will the Emory Regional Perinatal Center and Emory-Children's Center write off in costs of care? Whatever it is, says Jain, it'll be worth it.