There is a lot of terminology that you will hear when you have a baby in NICU, it can be daunting at first and you’ll wonder if you will ever understand what any of it means. You will find you soon pick it up and you will learn what is normal for your baby. I’ve compiled a list of common terms and issues below to help you get started but it’s by no means an exhaustive list. It covers a lot of the common terminology that we experienced in our time in ICU.
- Arterial blood gas (often just referred to as a “gas”) – A test carried out on a small amount of blood to analyse various features such as oxygen, carbon dioxide, PH level, billirubin level (for monitoring jaundice) and Hb (red blood count)
- Aspirate – This is what is removed from the stomach before tube feeds; a nurse will usually use a syringe to aspirate the stomach and test the contents to ensure the tube is still in the right place before feeding.
- Blood Transfusion – It is very common for premature babies to require a top-up of blood when their Hb levels are low. Henry had 12 in total. This usually improves their oxygenation and colour.
- Bradycardia (often referred to as a “brady”) – A drop in heart rate (usually less than 100 beats per minute), it can be quite scary when this happens as the oxygen saturations usually follow but is quite normal in premature babies and they grow out of it in time. Usually they will self-correct with their heart rate returning to normal by itself but sometimes they need intervention such as stimulation by poking, stroking or repositioning.
- Caffeine – Not for your afternoon coffee break! Premature babies are given caffeine as it helps them remember to breathe.
- Central Line – A line that is usually inserted in the leg or arm that is threaded through the body to the heart to deliver medication or nutrition.
- Chronic Lung Disease – A condition that is classified as a baby requiring ventilation for more than 28 days after being born and breathing support after 36 weeks gestation. Sometimes babies with this condition, like Henry, still require support when they are ready to leave hospital and will therefore be discharged on home oxygen.
- CPAP (Continuous Positive Airway Pressure) – Breathing support that is delivered through close-fitting prongs or a mask over the nose that delivers a continuous amount of air into the lungs at a set pressure.
- Endotracheal (ET) Tube – The breathing tube that is connected to the ventilator and sits inside the baby’s trachea to supply them with oxygen.
- Extubate – Removal of the ET tube. Ideally carried out by a nurse or doctor when a baby is ready to be taken off ventilator support although it is not uncommon for babies to dislodge the tube and extubate themselves. When this happens the medical staff will usually give them a trial off the ventilator before re-intubating. Henry extubated himself several times!
- Fontanelle – The soft spots at the top and back of the baby’s head.
- Haemoglobin (Hb) – The protein in the red blood cells that carries oxygen around the body. If this gets too low a blood transfusion is usually required.
- Heel prick – An easy way for blood samples to be taken by pricking the baby’s heel.
- Infection marker – A way of measuring infection levels in a baby. There are two tests for this; CRP and PCT. The CRP is the most commonly used marker as it requires less blood to be taken, if a baby is showing a CRP of greater than 10 usually antibiotics are started, if the CRP is above 20 often a lumbar puncture will also be carried out to rule out meningitis.
- Intravenous (IV) Lines and Infusion Pumps – The way fluids or medication are administered either through a central line or cannula. The infusion pumps given an accurate and controlled dosage.
- Intubation – Inserting an ET tube into a baby’s trachea to enable them to be ventilated.
- Jaundice – A common illness caused by raised bilirubin levels in the blood that give a baby a yellow tinge. Bilirubin is a yellow substance that is caused by the breaking down of red blood cells, this is usually removed from the blood by the liver but a baby’s liver isn’t fully developed so therefore can’t remove bilirubin efficiently at first.
- Kangaroo Care – The process of laying a baby on a parent’s chest skin-to-skin.
- Meconium – This is a baby’s first bowel movement and is usually very dark in colour.
- Nasal cannula/prongs – Tubes that deliver oxygen into a baby’s nostrils.
- Nasogastric Tube (NG tube) / Oralgastric Tube (OG tube) – The tube either inserted into the nose (NG) or mouth (OG) to enable a baby to be tube fed.
- Necrotizing Enterocolitis (NEC) – Inflammation of the underdeveloped intestinal wall and lining.
- Oxygen Saturations (sats) – The amount of oxygen circulating in the blood, measured using a sats probe which is usually attached to the hand or foot. Ideally this should be in the nineties but if you see a drop on the monitor always check your baby’s colour as well as sometimes the reading for this can be inaccurate if the baby is moving a lot.
- Patent Ductus Arteriosus (PDA) – A very common condition in premature babies where the blood vessel in the heart that links the aorta to the pulmonary artery does not close after birth. Sometimes this requires surgery but it is usually treated with Ibuprofen and in most cases closes after three doses.
- Phototherapy lights – Blue lights over the baby used to treat jaundice.
- Prone – Placing a baby so they are laying on their front.
- Retinopathy of Prematurity (ROP) – A common condition in premature babies born at less than 31 weeks gestation or weighing less than 1,250 grammes. It occurs when blood vessels in the eye grow abnormally. Stages 1 and 2 usually resolve themselves but if it gets to stage 3 corrective laser eye treatment is needed.
- Steroids – If time, these are given to the mother when she is in labour. They are also given to babies to help reduce swelling in their lungs.
- Suction – Removal of fluid or mucous from the lungs, usually when a baby is ventilated as secretions can build up in the ET tube.
- Surfactant – The lubricant that lines the air sacs in the lungs, very premature babies do not produce their own surfactant so artificial versions are usually given at birth if required.
- Total Parenteral Nutrition (TPN) – Nutrition that is given to a baby through an IV drip before they are receiving full milk feeds.
- Umbilical Catheter (UAC or UVC) – The tubes inserted through the belly button into the arterial (UAC) or venous (UVC) blood vessels, the UAC is used for taking blood samples and monitoring blood pressure. The UVC is used for administering IV fluids, TPN, drugs and blood products.
- Vapotherm – Breathing support that gives a pressured flow of oxygen to the baby through a nasal cannula. Usually the next step down from CPAP and is less invasive and more comfortable.
- Ventilation – Mechanical breathing support from a ventilator that pushes air into the baby’s lungs helping them to breathe.