Rainbow from Russia

A Russian tourist had vacationed to Dubai to enjoy the air of sophistication, warmth, and extravaganza. She did not bargain for the premature labour she went into by 6 months, leading to a precipitate delivery in NMC superspeciality hospital in Dubai. On 12 may 2010, An expert team of neonatologists headed by Dr. P K Rajiv received the baby 680 grams in the delivery room and put him on the ventilator. The babys aunty saw the tiny one, the size of a fist and literaly fainted. She asked anxiously does he have any chance? Dr. Rajiv opined that if he could cross 3 weeks braving lung failure, heart failure and a potential for bleeding in the brain., he has a fair chance to come out. Dr.Rajiv initial battle waswith underdeveloped lungs. The application of gentle ventilation he learnt in 1997 from University of IOWA did good for the baby. His application of volume targetting at 4ml/kg ( researched by him for 8 years) albeit the lowest level prescibed by literature, helped to bring the baby out of lung failure. His next battle was with a normal connection inside the womb called PDA which causes blood to bypass the body circulation and flood the lungs called in laymans terms heart failure. This was dexterously managed with fluid restriction and medication to constrict the PDA. The clinical silence of this dangerous condition made the baby come to minimal ventilator parameters by third week, A stormy battle was parallely fought with kidney failure, which improved with judicious fluid management. The excess of fluid loss after kidneys recovered protected the lung and heart failure. Meticulous infection control and dedicated nursing made the delicate one whose weight had reduced to 620 grams to come out of ventilator support to CPAP. A positive pressure device applied to the nose, by the third week and thestart of tube feeds. Dr Rajiv who was mentaly and physicaly present at the bedside for 3 weeks was thanked profusely by the mother. He said modestly "this baby is gods gift' I thank my entire staff and doctors for their committed care. Baby was transferred to Government hospital Al Rahbah Hospital under Dr.Junaid Khan a very experienced neonatalogist for financial and technical reasons and did very well. This baby has gone back to Russia, the mother with fond memories of Dubai, and the little bundle of joy a recepient of the most extraordinary care by man and god. Dr Rajiv reminesced that the fact that his little brain did not have a bleed despite his mode of delivery and his stormy ICU coursewas his destiny. He laughed and said "Who knows he may be the next premier of Russia'r