Progress for Preemies

When native New Yorker Steven M. Donn, M.D., began his fellowship in neonatology at the University of Michigan Medical Center in Ann Arbor, he began to notice that something was not quite right with the ventilators widely used for premature babies. "They weren't in synchrony with the baby's own breathing," explains Dr. Donn, 51, director of neonatal and perinatal medicine at C.S. Mott Children's Hospital. "They would drive oxygen into the baby's lungs when the infant might be exhaling." The result: Babies were more likely to suffer a ruptured lung and even brain damage.

But it wasn't until 1990 that the technology became available to detect minute changes in air flow and react lightning-fast-within 35 milliseconds-so the baby and the ventilator were working in unison. "When I heard about the new technology, I jumped all over it," says Dr. Donn, who had wanted to be a physician since he was a toddler. In the next several years, he led a series of clinical trials that showed babies treated with the new ventilators could breathe on their own six days earlier than those given the older types. The risk of complications was reduced, too.

One of Dr. Donn's first patients on the ventilator, now a 10-year-old basketball player, visited him last summer. "He was born under 24 weeks and weighed just a tad over a pound. No one thought he'd survive. But he did so well on the new ventilator that I extended the clinical trial so I wouldn't have to switch him to the older model," he recalls.

In the late 1990s, patient-triggered ventilators became the standard of care for infants. Dr. Donn is now studying other ways to combat brain damage and improve lung function in preemies.

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Progress for Preemies