Common Terms in the NICU

How We Learn About Your Baby

• Apgar Score – A measurement on a scale of 0-10 of your baby’s condition at one and five minutes after birth.
• Due Date (EDC) – The estimated time your baby was due to be born at full term or 40 weeks gestation.
• Full Term Baby – 37 to 42 weeks gestation.
• Grams vs. Pounds – Units of weight, 28 grams = 1 ounce, 454 grams = 1 pound.
• Large/Small for dates – A baby whose birth weight is more or less than the third percentile for that particular gestational age.
• Premature Baby – A baby born before 37 weeks gestation regardless of weight.
• Vital Signs – Your baby’s heart rate, breathing rate, blood pressure and body temperature.

Where Your Baby Will Be Staying

• Incubator (isolette) – A transportable, box-like enclosure in which sick or preterm babies are placed. Incubators provide for control of the temperature around the baby and limited protection of the baby from infectious agents.
• Open Crib – A regular hospital crib that your baby will be placed in when he/she is capable of maintaining his/her temperature on his/her own. When your baby moves to an open crib, he/she is getting close to going home.
• Pediatric Crib – A specialized crib with high side rails. Babies who suffer from reflux need the head of their beds to be elevated or they need to be placed on a reflux wedge. With a pediatric crib, nurses are able to raise the head of the bed higher than that of a regular open crib. The pediatric crib is also big enough to place a reflux wedge in it.
• Radiant Warmer – A bed that helps keep your baby at the right temperature. It may also be covered with plastic wrap for premature babies to keep more heat in the infant’s environment.
• Reflux Wedge – A special type of mattress that elevates the baby’s head of the bed at a much higher level than an open crib. These are used for babies with severe reflux.

Conditions You May Hear Us Discuss

• Apnea – An absence or prolonged pause in breathing (20 seconds or longer) typical in premature infants.
• Bradycardia (brady) – A significant slowing of the heart rate below the baby’s normal rate. Generally, for babies, a bradycardia is a heart rate less than 100 beats per minute.
• BPD (Bronchopulmonary Dysplasia) – A chronic lung disease primarily affecting premature infants who have been mechanically ventilated; involves air sac damage, scarring of the lung tissue, and areas of atelectasis.
• Desaturations (Desats) – Short periods of time when the oxygen level in your body’s system drops below an accepted level. This causes lack of oxygen to the tissues.
• Jaundice (hyperbilirubinemia) – The buildup of bilirubin in the fatty tissues that result in a yellow skin color.
• Meconium Aspiration Syndrome (MAS) – This happens when a baby inhales a mixture of meconium and amniotic fluid either in the uterus or shortly after delivery. Meconium may block the airway, causing difficulty breathing and poor gas exchange. This causes inflammation, which may result in pneumonia.
• PDA (Patent Ductus Arteriosus) – A condition where the ductus arteriosus, a blood vessel that allows blood to bypass the baby’s lungs before birth, fails to close after birth.
• Reflux – (Gastroespophageal Reflux) – The backward flow of stomach contents into the esophagus (food pipe); in babies reflux may trigger apnea and/or bradycardia.
• Residuals – Food remaining in the stomach from the previous feeding at the time of the next feeding. Large residuals indicate feeding intolerance.
• RDS (Respiratory Distress Syndrome) – A condition that affects the lungs of preterm newborns, making it difficult for them to breath. Caused by a lack of surfactant. Sometimes called hyaline membrane disease.
• Retinopathy of Prematurity (ROP) – A disease affecting the retina of a preterm baby’s eye. Involves rapid, irregular growth of blood vessels that can lead to bleeding and scarring of the retina. Can cause retinal detachment and blindness if severe. Premature babies will have scheduled exams of their eyes completed before they are discharged, and if the ROP is severe enough, laser surgery may need to be completed by a qualified Ophthalmologist. Southern Regional’s NICU is equipped with a Ret-cam, which is a retinal camera that takes pictures of the retina and detects any signs of ROP.
• Sepsis – The presence of harmful microorganisms in the blood and their effects on the body; a general infection.
• Surfactant – A soap-like substance (made up mainly of fat) produced by lung cells. Surfactant Coats inner surfaces of airways and air sacs in the lungs to keep those passages open between breaths. Absent or lacking in the babies born preterm (production begins at about 24 weeks gestation but is not well developed until 36 weeks).
• TTN (Transient Tachypnea of the Newborn) – A respiratory condition caused by delay in the body’s absorption after birth of the fluid that fills the fetal lungs.

Tests and Treatments Your Baby May Need

• Antibiotics – A drug that kills bacteria or reduces their growth. Used to treat infections.
• Barium Swallow – A set of X-rays taken to examine the esophagus, stomach, and small intestines. During the X-ray procedure, the baby is required to swallow a liquid form of barium that is detectable by X-ray imaging. This is sometimes used to determine if a baby is having reflux problems.
• Blood Gases – A laboratory test preformed on blood taken from an artery, capillary, or vein to determine levels of oxygen, carbon dioxide and acid.
• CT Scan – A method of body imaging in which a thin X-ray beam rotates around the baby.
• Echocardiogram (echo) – An ultrasound of the heart and heart functions.
• Head Ultrasound – A diagnostic imaging technique that makes images of the brain and is generally done at the bedside.
• Hyperal/TPN – The provision of essential nutrients (proteins, fats, sugar, vitamins, and minerals) and water through an intravenous line to replace or supplement a baby’s intake by mouth.
• Lipids – A group of substances that include fat, which are organic compounds made up of carbon, hydrogen, and oxygen.
• Oxygen – A molecule contained in air. Necessary for proper functioning of body cells. Absorbed into the blood from air breathed into the lungs (called oxygenation).
• Phototherapy Lights – Light treatment for hyperbilirubinemia. Light waves breakdown indirect bilirubin so that the baby’s system can eliminate it in urine.
• Surfactant Replacement Therapy – A treatment in which a preterm infant with expected or confirmed respiratory distress syndrome is given a natural or artificial substance (called an exogenous surfactant) through a tube placed in the windpipe to replace the natural surfactant the baby lacks because of early birth.
• X-ray – Radiant energy of short wavelength that penetrates substances opaque to light differently according to wavelength.

Equipment

• Breathing Tube (ET or Endotracheal Tube) – A tube that passes through the baby’s mouth and into the trachea (windpipe) to allow oxygen to be delivered to the lungs. Insertion of the tube is called “intubation”, and removal is called “extubation.”
• Cardiac Monitor – An electron device attached to babies in the NICU to monitor heart rate and rate of breathing; the monitor sounds an alarm if either falls below or exceeds a desirable level.
• Chest Tube – A tube inserted into your baby’s chest cavity to drain excess fluid or air.
• Conventional/Mechanical Ventilation (vent) – A mechanical breathing machine providing safe and effective ventilation to any baby requiring assistance. Mechanical ventilation in the neonate is typically accomplished by the use of a pressure-limited ventilator.
• High flow cannula – A respiratory device that warms and humidifies high flow rates of air/oxygen blends for delivery to a patient via nasal cannula.
• High Frequency Oscillator (HFO) – A mechanical breathing machine that provides ventilatory support but in a different way than a conventional ventilator or vent. The HFO inflates the baby’s lungs and holds them open constantly, while at the same time providing small puffs of air.
• Intravenous Live (IV) – A thin tube inserted into a vein by means of a needle (the needle is removed after the catheter is in the vein). It supplies medication, fluids or nutrients directly into the blood stream. May be placed in the hands, arms, feet, legs, or scalp.
• IV Pump – A large pump with chambers available to deliver continuous IV therapy and medications.
• Nasal Cannula – A small tube placed in your baby’s nose to give extra oxygen to your baby.
• Nasal CPAP (Continuous Positive Airway Pressure) – Air or an air/oxygen mixture mechanically pushed into a baby’s lungs to keep the air sacs open after each breath, reducing the effort the baby must make to breathe; usually delivered through short tubes placed in the nose.
• Nasojejunal Tube (NJ Tube) – A soft, flexible tube inserted into the nose, through the stomach, and then into the jejunum (a part of the small intestines). The tube carries formula and medicines into the jejunum where it can be quickly absorbed into the body. This is usually used for babies who have severe reflux.
• Orogastric Tube (OG Tube) – A feeding tube that is placed into your baby’s mouth and is advanced into his/her stomach. This tube may be used to feed or it may be used to remove air from the stomach. If placed through the nose, it is called a Nasogastric Tube (NG Tube).
• Oxygen Hood – A clear plastic box or hood placed over a baby’s head to hold supplemental oxygen. Also called an “Oxy-hood.”
• PICC Line (Peripherally Inserted Central Catheter) – A special intravenous catheter that is inserted into a peripheral (limbs) vein and threaded towards the heart. It is used for long term-fluid nutrition.
• Pulse Oximeter – A device that wraps around the hand or foot of a baby and uses a light sensor to determine the amount of oxygen bound to the hemoglobin molecules in the blood. It provides a general indicator of a baby’s oxygenation.
• Scale – A piece of equipment used to weigh babies. It may be free standing or incorporated into the baby’s bed.
• Suction Catheter – A tiny tube used to remove mucus from your baby’s nose, mouth, and windpipe.
• Syringe Pump – A small, single pump used to deliver medications or feedings.
• Transport Isolette – A mobile isolette specially equipped with oxygen. It is used in the transport of babies from one location to another (i.e. transports from one unit to another or from one hospital to another).
• Umbilical Catheter – A tiny catheter inserted into an artery and/or vein in your baby’s umbilical cord so that small amounts of blood can be drawn for tests without using a needle. The catheter in the artery also measures blood pressure. The catheter in the vein may be used to give fluids and medicines.