Specialists Sponsor Vast Changes in Nursery

              The Shreveport Times
Oil News
Sunday, Nov. 21, 1971
Classified
Metropolitan
News
Local News
Section C, Page One,
Dr. Juan J. Gershanik, new neonatologist with the Louisiana
State University Medical School at Shreveport, checks a
chart in the intermediate care section of the Confederate
Memorial Medical Center nursery, which has been re-organized
for better care of the newborns. At right is a close-up
of one baby being examined in its isolette. (Times Photos
by Billy Upstiaw)
Specialists Sponsor Vast Changes in Nursery
By Margaret Martin
Times Medical Writer
There's a revolution in the nursery.
It's a revolution which is changing the
physical set up, the equipment, the
philosophy, even the care of tiny babies.
It is fighting their special types of
diseases and keeping more of them alive.
It was started by and is being
nurtured by a group of p e d i a t r i c
subspecialists — neonatologists — who
take care of infants in the first 28 days of
their life.
Dr. Juan J. Gershanik is such a man.
A native of Argentina, he comes to
the Louisiana State University Medical
School at Shreveport as assistant profes-sor
in the Department of Pediatrics from
the Medical University of South Carolina,
Charleston.
At Charleston he held a Fellowship in
neonatology at the school which has what
is considered somewhat of a show piece
among intensive care nurseries in the
nation. He was also an instructor and
associate professor in pediatrics at the
school for two years.
And he plans to add Confederate
Memorial Medical Center's name to the
list of only 30 such centers in the U.S.
A delightful personality with a wide
smile Gershanik talks unabashedly with
emotion as he discusses "the babies in
the nursery."
Emotion with most neonatologists is
the rule, because they can't help but
become involved with their charges, an
involvement most doctors shy away
from.
An example is the story Gershanik
told about the 540 - gram (1 pound, 3 oz.)
baby born at the University of Kentucky
Medical Center, Lexington, Ky., where
he was a pediatric resident.
"We kept her alive for three months
in the nursery before she was released
and allowed to go home," he explained.
She lived for two and a half years, a
normal, healthy child, until recently
when Gershanik got a phone call.
"They told me she had died of
meningitis unrelated to her premature
start in life. I almost cried my lungs
out," he said.
This new breed of doctor Is part of the
revolution. •
The main thrust, of course, is that the
neonatal specialists are keeping babies
aiive today — with special equipment
scaled down to infant - size — who even
a few years ago would have been given
up as hopeless.
They are doing it in the intensive care
nurseries, where maximum care is
provided.
Gershanik explained that although
most of the time the normal newborn has
no trouble, there is a difference between
the fetus environment and the extraute-rine
life which can b.e a risk.
This is e s p e c i a l l y true for the
premature baby "who is not quite ready
to fight the environment in the same
condition as the full terin child isC"
With the premature babies, ne said,
"we need to • sort of: mimic the uterine
environment," trying "to provide the
same .-care -the;-mother in -ar-normal
situation provides." '
That's what the new subspeelality is
all about, the physician said, meeting the
needs of these newborns in the first four
weeks of their lives, at a time when they
have illnesses peculiar to their specific
age group.
"These are not just little people," he
said, "The newborns have their own
personality. Their own special disease
peculiar to them."
Included in these special problems
are respiratory troubles, one of the
leading causes of death among the
isolette crowd.
And among these respiratory troubles
is the dreaded hyaline m e m b r a n e
disease which occurs because the baby's
Related Story on Page 2-C
lungs are not fully d e v e l o p e d and
therefore do not function properly in
taking the oxygen from the environment
and getting rid of the carbon dioxide.
Today "we are able to monitor these
babies with electronic and laboratory
equipment, providing more adequate
care and improving the survival rate."
Doctors also work with very small
babies who "sort of forget to breathe,"
Gershanik said.
"We call them forgetful breathers,"
he added, explaining that this is a
particular interest of his. It is the topic
of at least one of the nine papers he has
published.
The new electronic monitors "sends
out a l a r m s when the baby stops
b r e a t h i n g , making the doctors and
nurses aware of the s i t u a t i o n so
immediate help can be provided."
There are also monitors to record the
baby's heartbeat. There are oxygen
detectors to determine how much oxygen
is in the baby's environment — too much
oxygen can cause blindness, while too
little can bring brain damage.
There is (equipment to monitor blood
pressure, blood gases and blood sugar.
The s p e c i a l i s t s have found that
although in normal births the umbilical
artery closes after a few days, it can be
opened with a tiny, hollow tube called an
umbilical catheter. This is passed into
the aorta and draws blood from the baby
without puncturing veins. It is also used
to feed the baby — who is too sick to be
fed by mouth — calories and fluids.
Although Confederate doesn't have all
of the special equipment yet, a tour
through the nursery shows some differ-ence
in it now and a month ago when
Gershanik arrived at the medical school.
Gone are the old fashioned incubators
and in their place the new type isolettes.
Doctors and nurses no longer have to
wear gowns to work with the babies
inside the isolettes.
"It's a hole new concept of keeping
the babies," explained Gershanik.
The babies have been placed into
three separate divisions: 1. Maximum
care, 2. Intermediate, and 3. The
graduates, or those ready to go home.
The lighting has improved, and Ger-shanik
hopes soon to have the partitions
within ttm rooms removed.
A third room ve r!ans to turn info a
•aboratory ("as soon as funds are avail-ible")
equipped with machinery which
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