Dozens Collaborate to Save "Miracle Baby" from CHAOS

08/24/2010 -

A Long Island boy born with a totally blocked airway – one of only 50 reported cases in the past 20 years – recently went home after four months in the Neonatal Intensive Care Unit at the Steven and Alexandra Cohen Children’s Medical Center of New York.

Justin Olivares recently greeted the world at a news conference accompanied by his parents Derly and Julian. The family thanked dozens of physicians and nurses who assisted in his dramatic delivery at Long Island Jewish (LIJ) Medical Center.

While he was still in his mother’s womb, clinicians detected Justin’s condition – known as congenital high airway obstruction syndrome (CHAOS) – during a prenatal exam at LIJ. Somewhere between six and eight weeks gestation, Justin’s airway failed to develop. Without surgical intervention, he wouldn’t be able to breathe once he was born. Besides cutting off oxygen, CHAOS causes fluid produced in the lungs to accumulate, dangerously enlarging the lungs. This lead to abnormal development and function of the lungs and diaphragm.

“The extreme challenge of CHAOS called for the close coordination of teams of physicians and nurses from numerous pediatric subspecialties at the Cohen Children’s Medical Center of New York (CCMC) with maternal/fetal medicine specialists from LIJ Medical Center and North Shore University Hospital,” said Dennis Davison, MD, chief of neonatology at CCMC. During Justin’s delivery, the clinical team established an airway while he was still supported by the placenta. This ensures that the baby received enough oxygen during the procedure so he could not suffer severe brain damage - or death.

The procedure was Justin’s only option and was a major risk to his mother. The clinical team decided to deliver the baby at 36 weeks, before Ms. Olivares went into labor, so physicians could control the complicated process of performing a tracheostomy (insertion of a breathing tube) while the baby was still attached to the placenta. In Justin’s case, the obstruction was bypassed by fetal surgery, and he was delivered and given oxygen through mechanical ventilation.

In addition to the blocked airway, it was discovered in utero that Justin would be born with ventricular septal defect - a hole in the wall between the heart’s two major pumping chambers. Fortunately, doctors, reported that the hole is beginning to close o it’s own, so cardiac surgery may prove unnecessary.

After treatment in the Neonatal Intensive Care Unit, Justin is breathing on his own, has developed normally, and is ready to live with his parents and 8-year old brother, Jason, who is very happy to be a big brother to his miracle baby.

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