Steroids to get off vent

schulme2

Hi Ladies!

My little man was born at 25 weeks and is now 3 weeks, 2 days. He started weaning off the vent for the past week and 1/2 but these past few days has been going backwards and requiring more oxygen and more BPM. He has MRSA and is finishing his 14 day course of vancomycin. The Dr. said that she wants to start him on steroids on Tuesday after he finishes his antibiotic. I don't know for sure what kind but she said it would be a 10 day course. I know there are side effects involved with the steroids but I'm worried about him continuing to go backwards. Has anyone else had to deal with deciding on steroids? Any regrets?

Courtneyw04

3 weeks is not a long time to be on the vent for a 25 weeker. They tend to need the extra support a little longer. If you are not 100% comfortable with the steroids make sure you ask lots of questions. We were offered the steroid course for one of our babies and declined after talking with the Drs on multiple occasions. With all the 25 weekers we saw in the NICU, including our own, they were on the vent anywhere from 1-8 weeks. With the average around 4-5. Our babies would get weaned and come off and then vented again a few days later. This is very typical and part of tht roller coaster you are on. Thoughts to you and your little man!

punky917

DS was a 26 weeker and had to be on steroids twice. It was 5 years ago so I am unsure how long each one was. The first one we completely agreed with since he had been on the vent for quite some time (about 2 months because of pneumonia 2 times in a row pretty much right after he was born). The next time, we were pretty upset that they gave it to him since he was regressing, but it was because a weekend nurse put him in an open crib and there was a note from his primary specifically saying not to because she didn't think he was ready. We didn't know that they didn't need our formal permission to administer it each time.

I agree with pp that you should ask a lot of questions especially if you are not comfortable and don't feel bad about saying no. I thought of it as a last resort intervention due to the side effects we were informed about. We don't regret agreeing to it the first time, but I really wish they did not do it that second round. We think he would have been ok if they just put him back in the incubator just a little while longer. Of course we were worried about the side effects in the future, but we weighed that against his struggle to breathe. It is definitely a tough decision, but for us it was the right one and we did not regret it because it helped him. Good luck with your decision and I will keep your LO in my prayers.

Jenrn2203

Our 24 weeker now 41 weeker has been on 2 long rounds of sterioids and is just finishing the 2nd round and last. She was on the vent a total of 7 weeks on and off due to failing of the Cpap and then a PDA ligation. If she wouldn't have gotten the sterioids I don't think she would be as comfortable. she is still breathing fast but managing and new lung tissue develops daily I highly recommend using them. Our daughter has had no side effects she is developing appropriately and is still on nasal cannula and will go home on it. This is a case where the benefits outway the risks. And you don't want your baby suffering because breathing is hard work !!!! Our daughter is also on neb treatments and I know they can use it when on the vent so maybe suggest that too!

DrRx

Using the steroids was a great decision for our 26-weeker, and absolutely no regrets.  She developed pneumonia about a week after she was on the vent and once she was finishing her round of antibiotics, she was actually getting worse and needed higher and higher settings.  She ended up needing to go on the oscillating vent because she maxed out on the conventional vent and that was when her neo talked to us about steroids.  He warned us of the possible risks, but said that in his professional opinion, the steriods would be the best decision for her. 

We agreed and she was started on them.  She was on the oscillating vent for 1 and 1/2 days, and then the regular vent for another 6 hours, and then they tried BiPAP and she didn't fail!