South Florida Hospital News
Tuesday March 26, 2019
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March 2019 - Volume 15 - Issue 9

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PREMIE BABY BORN AT 25 WEEKS SUFFERED NECROTIZING ENTEROCOLITIS, LEFT WITH ONLY 6 CM (2 INCHES) OF SMALL INTESTINE, HEADS HOME AFTER 206 DAYS IN THE NICU

Ramier Devilus’s small intestine rehabilitated in three months without surgery to 12 cm (4.7 in.); average infant has 130 cm (51.1 in.) of small intestine
 
Dr. Debora Duro and Salah Foundation Children’s Hospital are the only program in Florida that offer intestinal rehabilitation, providing option of forgoing multi-organ transplant 
 
Ramier will eventually be weaned off intravenous nutrition as his intestines regrow
 
After being born at 25 weeks weighing just 2 pounds, 4 ounces, Ramier Hezekiah Eusebio Devilus is heading home. At a press conference today at Salah Foundation Children’s Hospital at Broward Health Medical Center, the Devilus family shared how Ramier has experienced a miraculous recovery due to the intestinal rehabilitation provided by Debora Duro, M.D., director of pediatric gastroenterology and nutrition, and the specially-trained staff of the Neonatal Intensive Care Unit (NICU) at Salah Foundation’s Children Hospital.  
 
Ramier was born by emergency C-section on June 18, 2018, in Plantation along with his twin brother who, unfortunately, did not survive. Ramier developed necrotizing enterocolitis, a common complication of premature birth, which destroyed all but 6 cm of his small intestine, leaving Ramier unable to absorb nutrients from food. 
 
“My other son passed away,” said a tearful Rachell Eusebio, Ramier’s mother. “All my energy went into Ramier. I breastfed him. When he got the intestinal infection, it was really bad. They were telling me it was over for him and I couldn’t feed him anymore. My strength was taken away from me. We did a lot of praying.”
 
At 3 months old, Ramier was transferred to the NICU at Salah Foundation Children’s Hospital weighing just 6.7 pounds due to his short bowel syndrome and resulting liver disease. He was jaundiced, with even his eyes a light shade of yellow.  
 
Dr. Duro prescribed intestinal rehabilitation treatment, which uses personalized intravenous nutrition to ensure an infant receives proper nutrients for growth and development. In just a few months under Duro’s care, Ramier has regrown an additional six to eight centimeters of small intestine and now weighs 12.07 pounds. His liver numbers are now normal with no remaining evidence of liver disease.
 
“It has been a bumpy ride and challenging case,” said Duro, who is the only physician in Florida to offer intestinal rehabilitation, which prevents unnecessary multi-organ transplantation. “Ramier came to us very sick with an 80 percent mortality rate, and now he’s going home after three months totally healthy. Two or three years ago, Ramier would have remained in the hospital indefinitely, but today, because of the new personalized intestinal rehabilitation we can prescribe and the tools available for treatment, parents can continue the therapy at home.”
 
“Dr. Duro and this team are amazing,” said Eusebio, who dressed Ramier in cap and gown for his NICU graduation. “I went from thinking my son would never come home from the hospital, to now here we are going home at six months. First they started feeding him with a tube, then he was eating from his mouth. It was just success after success after success.” 
 
Duro added that because of the successful treatment, Ramier will not need a multi-organ transplant. “The best predictor of being able to come off intravenous nutrition is to receive care in an institution that does not offer intestinal transplant. We do everything we can to avoid transplant to give the child a normal life.”
 
When asked of Ramier’s long-term prognosis, Duro was very optimistic, saying Ramier will continue to be seen on a weekly, then monthly basis until the baby can be fully weaned off the intravenous nutrition. But in the meantime he will be at home with his 6-year-old sister Raziah and family.
 
“He will have a normal life,” added Duro, “going to school, giving mom grandchildren.” 
 
 
About Broward Health
Broward Health, providing service for more than 80 years, is a nationally recognized system in South Florida that offers world-class healthcare to all. The Broward Health system includes the statutory teaching hospital Broward Health Medical Center, Broward Health North, Broward Health Imperial Point, Broward Health Coral Springs, Salah Foundation Children’s Hospital, Broward Health Weston, Broward Health Community Health Services, Broward Health Physician Group, Broward Health Urgent Care, Broward Health International, and Broward Health Foundation. For more information, visit BrowardHealth.org.
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