Complete cleft lip and palate in a preterm infant: An airway management challenge on a neonatal unit

Prematurity combined with bilateral cleft lip and palate presents significant challenges in airway and respiratory management. This case report shares the experience of a neonatal intensive care unit (NICU) team where an instance of unplanned extubation challenged the team to consider solutions in supporting the airway, where standard non-invasive ventilation equipment was unsuitable due to the baby’s facial anatomy. The case focuses on the difficulties encountered, the innovative solutions implemented and the key lessons learned from this experience.

Dr Hannah Rogers
Paediatric Registrar ST5

Dr Sanjeev Rath
Consultant Neonatal Paediatrician

Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust

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Keywords

cleft lip and palate; prematurity; respiratory management

Key points

Prematurity combined with bilateral cleft lip and palate presents significant challenges in airway and respiratory management.
Managing a preterm baby with bilateral cleft lip and palate requires understanding of complex facial anatomy and addressing the associated airway management challenges.

Also published in Infant:

VOLUME 16/ISSUE 5, SEPTEMBER 2020

Bone health of extremely preterm infants: screening, monitoring and management of metabolic bone disease of prematurity

In this review article we summarise the pathogenesis of metabolic bone disease (MBD, also called osteopenia of prematurity). We consider the screening tools and the recommendations of professional bodies on management of MBD. We also present two case studies of long bone fractures in extremely premature infants following MBD. Based on the literature and our two cases, we propose a screening, monitoring and management algorithm for MBD of prematurity.