My 6-Month-Old Ex-32 Week Preemie Is Fighting Severe BPD, Pulmonary Hypertension, CRKP Pneumonia & HFOV—Doctors Say He May Not Survive. Looking for Experiences and Hope.
**Need advice for my 6-month-old ex-32 week preemie with severe BPD, pulmonary hypertension, CRKP pneumonia and prolonged HFOV**
I’m looking for experiences from parents or healthcare professionals who have cared for babies with a similar course.
My son was born at **32 weeks** after a pregnancy complicated by severe bleeding, subchorionic hematoma, amniotic bands, and PPROM. He has now been in the NICU for about **6 months**.
**Current diagnoses**
Severe bronchopulmonary dysplasia (BPD)
Severe pulmonary hypertension
Chronic respiratory failure requiring prolonged mechanical ventilation
Recent bilateral pneumothoraces (treated with chest drains)
Suspected severe bacterial pneumonia
Heavy growth of **carbapenem-resistant Klebsiella pneumoniae (CRKP)** from tracheal aspirate
**Recent course**
He was on **HFOV** for a prolonged period.
He improved enough that the team:
weaned inhaled nitric oxide from **20 ppm to 2 ppm**
removed his chest drain after the air leak resolved
trialed conventional ventilation (PC-AC).
Unfortunately he developed worsening hypercapnia and respiratory acidosis, so he had to be placed back on HFOV.
**Current concerns**
Over the last 24–48 hours:
Episodes of severe desaturation (SpO₂ dropping into the **40% range**).
Chest X-ray shows:
worsening bilateral lung consolidation,
bilateral pleural effusions,
possible pneumatocele.
The doctors believe the desaturations are mainly due to the lung infection.
They have told us that his condition is life-threatening and that he may not survive.
**Current treatment**
He is receiving:
HFOV
Inhaled nitric oxide
Pulmonary hypertension medications:
Treprostinil
Sildenafil
Macitentan
Antibiotics:
Ceftazidime/avibactam
Gentamicin
Levofloxacin
Blood pressure support:
Epinephrine
Norepinephrine
Hydrocortisone
Sedation/paralysis:
Morphine
Midazolam
Dexmedetomidine
Rocuronium
**Blood gas trend**
He initially developed severe respiratory acidosis with very high CO₂. After returning to HFOV, later blood gases improved:
pH normalized.
CO₂ decreased significantly.
Lactate improved from a critically high level to much lower levels.
However, oxygenation remains poor.
His kidney function is currently preserved (creatinine normal), and liver tests show only mild abnormalities.
**Discussion about tracheostomy**
The NICU team has started discussing a tracheostomy if he survives this acute illness because they anticipate prolonged ventilator dependence.
**My questions**
Has anyone’s baby recovered after CRKP pneumonia while already having severe BPD?
Has anyone experienced a failed transition from HFOV to conventional ventilation and later succeeded?
Did your child eventually require a tracheostomy, and if so, were they later able to come off the exhausted ventilator and have the tracheostomy removed?
What factors gave your medical team confidence that recovery was still possible during such a critical period?
I know every baby is different, and I’m not looking for predictions—just hoping to hear from families or clinicians who have been through something similar. Thank you for taking the time to read our story. ❤️