Common Terms used in NICU

ABG's:

• Arterial Blood Gases. Blood drawn from an artery used to measure the amount of oxygenated blood

• Build up of acid in the blood

Anemia:

• A condition in which the red blood cells in the blood — measured by a hematocrit, or "crit" — are lower than normal. Red blood cells carry oxygen and carbon dioxide to and from tissue

Angiogram:

•    an x-ray of the hearts blood vessels assisted by a x-ray dye (contrast) injected through a catheter

•    a medication given to help prevent blood clots from forming

• 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.

Arrhythmia

• Out of rhythm - the heart is beating too fast, too slow, or irregularly

Ascites

• Buildup of fluid in the abdominal cavity

Aspiration

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

Alveoli

• Air sacs in the lungs where oxygen and carbon dioxide are exchanged

Balloon Catheter

• A catheter with a balloon at the tip, which can be used to open a blocked heart artery . Also used sometimes to open blocked valves.

Betadine

• An orange-colored skin disinfectant.

Biopsy

•  Removal of a small piece of tissue for examination

Blue Blood

• Blood which is returning from the body to the heart and so pumped to the lungs, where it will pick up oxygen and become red blood

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 Urea Nitrogen (BUN)

• A blood test that measures how well the kidneys are functioning.

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. For more information on BPD, visit the American Lung Association® site.

BROVIAC® Catheter

• Type of intravenous tube used to give fluids and medications to infants or children. The catheter is placed in a major vein of the body during surgery. The BROVIAC® catheter is designed to stay in place over many months, if needed. There are other types of catheters with different names, all of which serve the same function.

Caffeine citrate  

• A central nervous system stimulant that's used to treat certain breathing problems in some preemies. This medication is given intravenously.
• Capillaries smallest blood vessels connecting arteries and veins where oxygen and nutrients are exchanged for waste products

Cardiac output

• The amount of blood the heart pumps through the circulatory system in 1 minute (stroke volume multiplied by heart rate)

Cardiopulmonary bypass

• Method by which a machine takes over the function of the heart and lungs so the heart can be stopped for surgery

Catheter

• Long, thin flexible, hollow tube inserted through an incision or needle prick into blood vessels, or through openings in the body

Catheterization

• Any procedure in which a catheter is inserted into the body; it can be used to assess the condition of coronary arteries, valves, and heart muscle and to open blocked arteries and reshape heart valves. Also, a diagnostic procedure which is a comprehensive examination of how the heart and its blood vessels function.

Cardiologist

• Doctor who specializes in the heart

Cardiomyopathy

• A disease of the heart muscle

Chest Tube:

• Hollow, flexible drainage tubes used to drain away fluid, blood or air and allow full expansion of the lungs

CT Scan or CAT Scan:

• Computed Axial Tomography A scan which uses computers to generate a three-dimensional image.

Congenital

• Describes a condition which is present at birth

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.

Charge Nurse

• The registered nurse who has general responsibility for coordinating the nursing care of all babies in a unit for a particular shift.

CHF

• Congestive Heart Failure -CHF is a condition in which the heart is unable to circulate enough oxygenated blood to the body because it's not pumping strongly. This inefficient pumping causes the blood to back up in the veins. The body then retains fluids.

Continuous Positive Airway Pressure (CPAP)

• Supplemental oxygen or room air delivered under pressure though either an endotracheal 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.

Coil

• Stainless steel device permanently placed in extra blood vessels going into the lungs, in order to block blood flow.

Collateral

• Vessels -extra, small, secondary (accessory) blood vessels that develop to bypass narrowed or blocked veins or arteries on the heart.

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.

Diastolic pressure

• The lower of the two numbers used to measure blood pressure; indicates pressure as the heart relaxes.

Dilate

• Open; widen

Diuretic

• A medicine used to increase urine output.

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.

Electrocardiogram (ECG or EKG)

• A test that records the electrical activity of the heart. It can show abnormal rhythms (arrhythmias or dysrhythmias) or detect heart muscle damage.

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.

Extracorporeal Membrane Oxygenation (ECMO)

• This long name means "oxygenation outside the body." It's used for babies whose lungs are not working properly (i.e., transferring oxygen into the blood and removing carbon dioxide) despite other treatments. The ECMO takes over the work of the lungs so they can rest and heal. It's similar to the heart-lung bypass used during some types of surgeries.

Extubation

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

Fontanelle

• The soft spot on the top of the head. At birth the skull is made of up of several plates of bone; it is not a single, solid bone. The spaces between the bone plates allow the skull to expand as the brain grows. Where four of these bony skull plates come together it forms a soft spot in the skull called a fontanelle. There is no bone in these soft spots, making these areas softer than the surrounding areas. There are usually two soft spots in the skull of a newborn, the anterior and the posterior fontanelle; both usually close by about 18 months of age.

Gastric Tube (g-tube)

• A soft flexible tube that is placed through the skin into the stomach

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.

Gram (GM, gm, G)

• The basic unit of weight in the metric system (28 grams = one ounce).

Heart Murmur

• A noise heard between beats of the heart. Innocent, functional heart murmurs are common and often heard in infants and toddlers.

Heart Cath

• A test in which a catheter (or thin tube) is passed through a blood vessel into the heart to study the heart anatomy and the function of the heart.

Heart-lung machine

• A machine that supplies blood with oxygen and  pumps it throughout the body while the heart is stopped during open-heart surgery.

Heel Stick

• Pricking the baby's heel to obtain small amounts of blood for testing.

Hemaglobin

• A material in red blood cells that carries oxygen and contains iron.

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).

Hyaline Membrane Disease (HMD)

• Another name for respiratory distress syndrome (RDS).

Hypertension

• High blood pressure.

Hypoplastic

• Underformed with lack of normal function.

Hypotension

• Low blood pressure.

Idiopathic

• Something which happens spontaneously or from an unknown cause.  

Input & Output

• Refers to the amount of fluids given by oral feedings and/or by IV, and the amount of fluid excreted in the urine or stools.

Ileal Perforation

• Puncture or hole in the last part of the small bowel (ileum). This usually occurs spontaneously in extremely premature babies. Its cause is unknown. Often an ileal perforation requires surgery to form an ileostomy and to repair the hole in the bowel.

Incubator

• Another name for an isolette.

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 lose heat very quickly unless they are put in a protected thermal environment. Newborns are also not able to regulate their body temperature.  The temperature of the isolette can be adjusted to keep the infant warm regardless of the infant's size or room temperature.

IV Antibiotics: (Intra-Venous)

• Antibiotics given directly into the blood

IV Drugs

• Drugs given directly into the blood stream

IVC

• Inferior vena cava -the large vein that returns blue blood from the lower body to the right atrium in the normal heart

Jaundice

• Also known as Hyperbilirubinemia. Jaundice comes from the accumulation of a natural waste product, bilirubin. As red blood cells and other tissues are replaced in the body, the waste products of their breakdown are normally eliminated by the liver. Bilirubin has a yellow color, and when the levels are high it stains the skin and other tissues.

Jugular veins

• Veins that carry blood back from the head to the heart

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.

Lead Wires

• Wires connecting the sensors on the baby's chest to the vital signs monitor.

Left heart failure

• Blood flow to the body is decreased and fluid accumulates in the lungs.

Lumbar Puncture (LP)

• Also known as a "spinal tap," this test involves inserting a hollow needle in between the vertebrae of the lower back to collect a sample of cerebrospinal fluid.

Magnetic Resonance Imaging (MRI)

• Imaging technique that uses powerful magnets and computers to produce a detailed picture of tissue.

Meconium

• A dark green, sticky mucus, a mixture of amniotic fluid and secretions from the intestinal glands, normally found in infants' intestines. It is the first stool passed by the newborn. Passage of meconium within the uterus before birth can be a sign of fetal distress. The meconium is very irritating to the lungs.

Monitor

• Machine that displays and often records the heart rate, respiratory rate, blood pressure and blood oxygen saturation of the baby. An alarm may sound if one or a number of these vital signs are abnormal. False alarms are common, as abrupt movements can cause the monitor to register inaccurate readings — a good general rule of thumb is "Look at the baby, not the monitor."

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.

Neonate

• A term used to describe an infant during the first 30 days of life.

Neonatologist

• A pediatrician who has received 4-6 years of training after medical school in preparation for treating premature or sick newborns.

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 non invasive machine allows the NICU staff to monitor the amount of oxygen in the baby's blood without having to obtain blood for laboratory testing.

Oxygen Hood

• A clear plastic box that fits over a baby's head and supplies him or her with oxygen. This is used for babies who can breathe on their own, but still need some extra oxygen.

Pacemaker

• A small battery-powered implantable device placed under the skin and joined to the heart by pacing wires, which electrically stimulates the heart to contract and pump blood throughout the body

Pacing box or External pacer

• A medical advice designed to regulate the electrical activity of the heart. It either stimulates or regulates the hearts electrical activity when the rate is not fast enough.

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.

• Circulation of blood through organs or tissues.

Pericardium

• The sac or membrane surrounding the heart.

Persistent Pulmonary Hypertension of the Newborn (PPHN)

• High blood pressure in the lungs, which causes the small blood vessels in the lungs to become progressively narrower.  It can lead to breathing problems and reduced levels of oxygen in the blood.  Sometimes treated with nitric oxide, a gas naturally produced by the body that can help expand blood vessels.

Phototherapy

• Light therapy to treat jaundice. Bright blue fluorescent lights, called bililights, are placed over the baby's incubator.

PICC Line

• A special IV line used to provide fluids into a vein. A PICC line is usually very stable and lasts longer than a typical IV.

Pneumothorax

• When air from the baby's lungs leaks out into the space between the baby's lungs and chest wall. While small leaks may cause no problems and require no treatment, larger leaks may cause serious complications such as lung collapse and may need to be repaired with surgery.   

Prophylactic

• Describes a medicine or procedure intended to prevent illness

Prostaglandin

• A drug used to keep the patient ductus arteriosus (PDA) from closing

Pulmonary

• To do with the lungs

Pulmonary Artery

• The blood vessel that takes blood from the heart to the lungs

Red Blood

• Blood which has picked up oxygen from the lungs and travels through the left side of the heart to be pumped around the body

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.
• The RSV season is usually from October to March.

Retraction

• An abnormal sucking in of the chest during breathing, indicating that the baby is working too hard to breathe.

Right heart failure

• Decreased blood flow resulting in swelling in the legs and abdominal organs, including the liver.

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.

Septal defect

• A hole in the wall separating the atria or in the wall separating the ventricles

Septum

• The wall between the left and right chambers of the heart

Shunt

• A natural or artificially created passageway that redirects the circulation of blood or cerebral spinal fluid

Sonogram

• Another name for an ultrasound.

Stenosis

• A narrowing, usually refers to a valve or blood vessel.

Stent

• A stainless steel mesh tube placed inside an artery to hold it open after angioplasty has pushed aside a blockage

Systolic pressure

• The higher of the two numbers used to measure the blood pressure; indicates pressure as the heart contracts

Supraventricular Tachycardia

•  (SVT) a very fast heart beat

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.

Swaddling

• Securely wrapping a baby in a light blanket to soothe and/or restrain him or her. The NICU nurses can teach you how to swaddle your baby.

Tachycardia

• A faster than normal heart rate.

• A faster than normal respiratory rate.

• Windpipe

• A hole cut into the windpipe to help breathing

• Valve between the right atrium and ventricle.

• The baby's feed is given through a tube in the nose directly into the stomach - this is so that breathless babies can get enough food

• 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.  This prevents lots of needle pricks!

Umbilical Venous Catheter (UVC)

• Catheter (small tube) placed in the belly button vein. It is used to give the baby fluids and medications.

• Medications that widen or dilate the arteries

• A blood vessel that returns blood to the heart from the body or lungs

• 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

• One of two large lower pumping chambers of the heart

•  A hole in the wall that separates the right and left ventricles of the heart allowing crossover of blood

Vital Signs Monitor

• A machine measuring and displaying heart rate, breathing rate, and blood pressure on a computer screen. If these vital signs become abnormal, an alarm usually sounds.

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. Generally, a baby progresses from a warmer to an isolette to an open crib before leaving the NICU.