NICU ABC's

Acidosis
Too much acid in the body, a distinctly abnormal condition resulting from the accumulation of acid or from the depletion of alkaline reserves. In acidosis, the pH of the blood is abnormally low. Acidosis is associated with diabetic ketocidosis, lung disease, and severe kidney disease. The opposite of acidosis is alkalosis in which there is too high a pH due to excess base or insufficient acid in the body.

Anemia
A condition in which the red blood cells in the blood — measured by a hematocrit, or "crit" — are lower than normal.

Adjusted Age
Also known as "corrected age." This is your child's chronological age minus the number of weeks he or she was born early. For example, if your 9-month-old was born 2 months early, you can expect him or her to look and act like a 7-month old. Usually you can stop age-adjusting by the age of 2 or 3.

Apgar Score
A numerical summary of a newborn's condition at birth based on five different scores, measured at 1 minute and 5 minutes. (Additional measurements are made every five minutes thereafter if the score is less than 7 at five minutes, until the score reaches 7 or greater.) Premature infants generally have lower scores than full-term infants, but the Apgar score does not accurately predict future development.
Cessation of breathing lasting 20 seconds or longer. Also known as an apneic episodes or apneic spells. It is common for premature infants to stop breathing for a few seconds. They almost always restart on their own, but occasionally they need stimulation or drug therapy to maintain regular breathing. The heart rate often slows with apnea; this is called bradycardia. The combination of apnea and bradycardia is often called an A&B spell.

Aspiration
The accidental sucking in of food particles or fluids into the lungs.
Removal of a sample of fluid and cells through a needle.

Bilirubin
Yellow chemical that is a normal waste product from the breakdown of hemoglobin and other similar body components. The placenta clears bilirubin from the fetus's blood, but after delivery this task belongs to the infant. It usually takes a week or more for the newborn's liver to adjust to its new workload. When bilirubin accumulates, it makes the skin and eyes look yellow, a condition called jaundice.

Blood Gas
A blood test used to evaluate an infant's level of oxygen, carbon dioxide and acid. This test is significant because it helps to evaluate an infant's respiratory status.

Bradycardia ("Brady")
An abnormally low heart rate. Bradys are usually associated with apnea in premature infants. During these spells the infant will stop breathing for at least 15 seconds and the heart rate will start to slow, also referred to as an "A&B spell." Gentle touching or other stimulation almost always restarts the breathing and increases the heart rate. Medications (theophylline or caffeine) are often used to treat these spells in newborn babies.

Bronchopulmonary Dysplasia (BPD)
A chronic lung disease of babies, when the lungs do not work properly and the babies have trouble breathing. It is often diagnosed when a premature baby with respiratory problems continues to need additional oxygen after reaching 36 weeks gestational age. Also referred to as Chronic Lung Disease (CLD), it is most common in babies who are born before 34 weeks gestation. Doctors think babies get BPD because their lungs are sensitive to something damaging in the environment, such as oxygen, a breathing machine, or an infection.

Central Venous Line (CVL)
The central venous line (CVL), also called the central venous catheter (CVD), is a type of intravenous tube used to give fluids and medications. The catheter is placed in a major vein of the body during surgery or by insertion through a vein in the arm, leg or head.

Continuous Positive Airway Pressure (CPAP)
Supplemental oxygen or room air delivered under pressure though either anendotracheal tube (tube that goes directly into the infant's lungs) or small tubes or prongs that sit in the nostrils. Delivering oxygen under pressure helps keep air sacs in the lungs open and also helps maintain a clear airway to the lungs. Nasal CPAP (NCPAP) is commonly used immediately after removing the endotracheal tube to treat apnea and/or prevent the need for an endotracheal tube and ventilator.

Crit
Slang for hematocrit, this is a test used to determine the percentage of red blood cells compared to total blood volume. It is commonly used to test for anemia. It is significant in that is helps show a baby's ability to supply oxygen to his or her organs and tissues.

Echocardiogram (“Echo”)
Ultrasound picture of the heart. This is a painless, non-invasive procedure that takes accurate pictures of almost all parts of the heart. Many preemies have a cardiac ultrasound if the doctor is looking for evidence of a patent ductus arteriosus.

Edema
Puffiness or swelling, usually because of fluid retention in the body tissues.

Endotracheal Tube (ETT or ET Tube)
Tube placed through the mouth or nose into the throat and the child's trachea (windpipe). This tube provides a secure pathway through which air can be circulated to the lungs.

Extremely Low Birth Weight (ELBW)
A baby born weighing less than 2 pounds, 3 ounces (1,000 grams). Also known as a "micropreemie."

Extubation
Removing the Endotracheal Tube (ET Tube) from the baby's windpipe.

Gavage Feeding
Feeding a baby through a nasogastric (NG) tube. Also called tube feeding.

Gestation
The period of development from the time of fertilization of the egg, until birth. Normal gestation is 40 weeks; a premature baby is one born at or before the 37th week of pregnancy.

Gram (GM, gm, G)
The basic unit of weight in the metric system (28 grams = one ounce).

Grasping Reflex
A newborn's reflexive grab at an object, such as a finger, when it touches her hand. This grasp may be strong enough to support the infant's own weight, but doesn't last very long. This reflex lasts until a baby is 3 or 4 months old. Newborns have many naturally occurring reflexes.

High Frequency Oscillatory Ventilator
A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator (for example, 120 - 1,320 BPM, or Breaths Per Minute).

Intrauterine Growth Retardation (IUGR)
A condition in which the fetus doesn't grow as big as it should while in the uterus. These babies are small for their gestational age, and their birth weight is below the 10th percentile. IUGR can be caused by decreased blood flow to the placenta, maternal hypertension, drug use, smoking, poor weight gain, dieting during pregnancy, pre-eclampsia, alcoholism, multiple fetuses, abnormalities of the cord or placenta, prolonged pregnancy, chromosomal abnormalities, or a small placenta.

Intravenous (IV)
A catheter (small tube) placed directly through the skin into the vein in a baby's hand, arm, foot, leg or scalp. Nutrients, fluids and medications can flow through this tube. Using an IV is a common route for delivering fluids to newborns and other patients. Babies' veins are very fragile, so the location of the IV may need to be changed frequently.

Intubation
Inserting a tube into the trachea (windpipe) through the nose or mouth to allow air to reach the lungs.

Isolette
Also known as an incubator, an isolette is a clear plastic, enclosed bassinet used to keep prematurely born infants warm. Preemies often loose heat very quickly unless they are put in a protected thermal environment. The temperature of the isolette can be adjusted to keep the infant warm regardless of the infant's size or room temperature.

Kangaroo Care
Skin-to-skin contact between parent and baby. During kangaroo care, the baby is placed on the parent's chest, dressed only in a diaper and sometimes a hat. The baby's head is turned to the side so the baby can hear the parent's heartbeat and feel the parent's warmth. Kangaroo care is effective, but it's limited to babies whose condition is not critical.

Nasal Cannula
Light, flexible tube used to give supplemental oxygen to a child. Oxygen flows through two prongs extending into the nostrils.

Nasogastric Tube (NG Tube)
Narrow, flexible tube inserted through the nostril, down the esophagus, and into the stomach. It is used to give food or to remove air or fluid from the stomach.

Nebulizer Treatment
A nebulizer humidifies air and/or oxygen that is passed to the infant. At home, a nebulizer is a way of delivering medication -- it transforms medicine into droplet form for inhalation. Used for a variety of lung problems.

Necrotizing Enterocolitis (NEC)
Swelling, tenderness and redness of the intestine caused by an infection or decreased blood supply to the intestine. The seriousness of NEC varies: it may injure or destroy parts of the bowel, or it may affect only the innermost lining or the entire thickness of the bowel.

NPO
An abbreviation for a Latin term that means "nothing by mouth" -- i.e., no food or water.

Oximeter (Pulse Oximeter)
Machine monitoring the amount of oxygen in the blood. A tape-like cuff is wrapped around the baby's toe, foot, hand or finger. This machine allows the NICU staff to monitor the amount of oxygen in the baby's blood without having to obtain blood for laboratory testing.

Parenteral Nutrition (Hyperalimentation)
Solution put directly into the bloodstream, giving necessary nutrients, such as protein, carbohydrates, vitamins, minerals, salts, and fat. Other names for this are hyperal, total parenteral nutrition (TPN) and intravenous feedings.

Patent Ductus Arteriosus (PDA)
The ductus arteriosus is a blood vessel connecting the pulmonary artery and the aorta. Before birth, this vessel allows the baby's blood to bypass the lungs because oxygen is supplied by the mother through the placenta. The ductus arteriosus should close soon after birth. If it does not, it is called a patent (open) ductus arteriosus, or PDA. A PDA may be treated either with medication or surgery.

Respiratory Distress Syndrome (RDS)
Respiratory problems due to lung immaturity. Respiratory distress is a much more inclusive term meaning simply that the child is having problems breathing. Respiratory distress syndrome is a specific condition that causes respiratory distress in newborn babies due to the absence of surfactant in the lungs. Without surfactant, the alveoli (air sacs) collapse when the baby breathes out. These collapsed air sacs can only be reopened with increased work at breathing. Most newborn babies do not have a normal amount of surfactant in their air sacs until 34 to 36 weeks' gestation. However, some very premature infants (27 to 30 weeks' gestation) will have adequate surfactant production and function and some full-term infants (37 to 40 weeks' gestation) will not.

Respiratory Syncytial Virus (RSV)
The most common cause of bronchiolitis in young children. Bronchiolitis is an infection of the bronchial tubes that causes rapid breathing, coughing, wheezing and sometimes, even respiratory failure, especially in the first two years of life. RSV infection and bronchiolitis is a particular risk for infants with chronic lung problems and those born prematurely.

Retinopathy of Prematurity (ROP)
Scars and abnormal growth of the blood vessels in the retina, the layer of cells in the back of the eye. The retina does not mature until close to term (40 weeks gestation), so when babies are born very prematurely, the normal growth of blood vessels into the retina is altered. These abnormally growing vessels can eventually lead to disruption of the retina and the loss of eye function.

Room Air
The air we normally breathe, which contains 21% oxygen. When supplemental oxygen is given for respiratory problems, it is in concentrations higher than 21%.

Sats
Term for blood oxygen saturation.

Sepsis
A potentially dangerous infection of the bloodstream which occurs when the body's normal reaction to inflammation or a bacterial infection goes into overdrive. Certain lab tests, cultures, and x-rays can help diagnose this condition, which is treated with antibiotics

Surfactant
Surfactant is a soapy material inside the lungs of adults and mature infants that helps the lung to function. Without surfactant, the air sacs tend to collapse on exhalation. Lung surfactant production is one of the last systems to mature in an infant, which can cause the breathing problems found in preemies.

Synchronized Intermittent Mandatory Ventilation (SIMV)
The ventilator mode where the mechanical breaths given by the ventilator are synchronized with the baby's spontaneous (regular) breaths.

Ultrasound
Imaging of body parts using sound waves. The reflected sound waves are then analyzed by computer and turned into pictures.

Umbilical Arterial Catheter (UAC)
Catheter (small tube) placed in a belly button artery. It is used to check blood pressure, draw blood samples and give fluids.
Umbilical Venous Catheter (UVC)
Catheter (small tube) placed in the belly button vein. It is used to give the baby fluids and medications.

Ventilator (“Vent”)
A machine that assists adults or children to breathe. Lung immaturity in prematurely born infants is the most common reason for a newborn to require a ventilator.

Warmer
Also known as a Radiant Warmer, this bed allows maximum access to a sick baby. Radiant heaters above the bed keep the baby warm.