Ezra’s birth was a surprise.

On Oct. 2020年11月23日，他只有23周的妊娠期，处于生存的边缘. He weighed 1 pound, 0.6 ounces at birth.

“He was not supposed to arrive this early,” Olivia, his mother, says, 但我的医生担心我的高血压会导致中风, so Ezra was born by emergency C-section.”

Premature birth may bring a host of complications, including underdeveloped lungs, heart conditions, temperature regulation issues, brain development, vision problems and more.

Ezra needed expert care from an experienced team, so after three months at a South Florida hospital, he was transferred by LifeLine ambulance to the neonatal intensive care unit (NICU) at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. The NICU carries a Level IV rating, the highest given by the American Academy of Pediatrics, 该团队对极低和极低出生体重的婴儿有着丰富的经验. 新生儿科团队在2021-2022年全美排名第45位.S. News & World Report.

“以斯拉出生时，早产婴儿的生存能力已经到了极限，”他说 Joana Machry, M.D.她在约翰霍普金斯儿童医院专攻新生儿医学 Maternal, Fetal & Neonatal Institute. “这个年龄段的存活率非常有限，可能会伴随着各种各样的医学并发症.”

以斯拉的情况需要的不仅仅是传统的新生儿护理. 他需要全医院的专家组成的团队. Fortunately, 约翰霍普金斯儿童医院连续第二年在8个儿科专科排名全国第一, which is unmatched by any other Florida hospital.

The priority was Ezra’s heart.

Specialists from the Johns Hopkins All Children’s Heart Institute 必须关闭主动脉和肺动脉之间的小连接吗. The transcatheter procedure uses a pea-sized device, 它被称为Amplatzer Piccolo闭塞器，用来关闭心脏上的一个开口，这个开口通常在足月分娩后会自行关闭. 但像以斯拉这样的早产儿需要做一个手术来关闭开口并解决循环问题.

After the “Piccolo” procedure was complete, Ezra began to thrive a bit more, 但是由于他严重的早产以及肺部积液过多的长期影响, he continued his journey suffering from bronchopulmonary dysplasia (BPD), a form of chronic lung disease. 因为需要呼吸机的长期支持, 他还需要气管切开术，以便更安全地向他发育不全的肺部输送空气和氧气.

“Looking back, 把他转到约翰霍普金斯儿童医院是我们做过的最好的决定之一,” Olivia says. “After his first week here, a team of doctors and nurses had him stabilized, 评估了他的健康问题并准备好了护理计划.”

以斯拉面临的另一个挑战是早产儿视网膜病变(ROP)。, 一种主要影响早产儿的潜在致盲性眼部疾病. 约翰霍普金斯儿童医院与州外的一家医院合作，这家医院在以斯拉需要的手术方面有专业知识. 他被送到那家医院做手术，然后又回到约翰霍普金斯儿童医院继续康复.

“It takes a multidisciplinary team, which includes neonatologists, cardiologists, pulmonologists and the tracheostomy team, to care for premature babies that are fragile like Ezra,” Machry says.

Machry, 他也是约翰霍普金斯大学医学院的助理教授, has experience with many complex long-term NICU patients. 她跟随最新的技术和新生儿护理的研究，无论是在她的临床职责和约翰霍普金斯所有儿童的主任 Neonatal-Perinatal Fellowship Program.

“以斯拉在新生儿重症监护室已经成为我们家庭的一员，因为我们照顾了他这么长时间, and I’ve been part of his care team since his arrival,” she says. “For me as a physician, he has been a challenge. 他是一个推荐十大正规网赌平台，需要我们不断地回顾他的图表，阅读文献，以了解我们可以帮助他的方法.

“他得到了一定程度的支持和技术，这是我们10年前通常不会提供的,” she explains. “For instance, 我们有一个呼吸机诊所和一个多学科团队(气管切开术团队)，处理NICU中需要慢性机械通气的患者的所有复杂性.

“We can also offer medications to treat a condition called pulmonary hypertension. 而且，我们可以选择让推荐十大正规网赌平台从重症监护室出院，接受慢性呼吸支持. In the past, 带着呼吸机回家并不是我们通常提供给推荐十大正规网赌平台的选择, and they were bound to the hospital. Now there is the possibility of being discharged. This is what we are working on for Ezra.”

As he grows older and stronger, Ezra likely will overcome some of his challenges, 但他的极度早产会产生一些持久的影响.

奥利维亚说:“他经历了许多艰难的时刻，但他每次都挺过来了。. “他很有韧性，随着年龄的增长，他会克服这些健康问题, although he will most likely be vision impaired for life. We hope he will finally be discharged in January. 这将是一个伟大的回家，因为这将是他第一次离开医院. 这让我们在新的一年里有所期待，因为我从未完全失去希望.”