Terms Associated with the NICU and Premature Babies
Stick around any venue long enough and you are bound to pick up the lingo of the locals. We spent nearly five months on the Infant Special Care Unit and then another six weeks in the Intensive Care Unit at Children’s Hospital in Chicago when Molly had open-heart surgery. It didn’t take long for us to start sounding like one of the natives, and there is a lot of medical shorthand in the journal entries posted on our Home page. This glossary should help (please see disclaimer at the bottom of the page). Additional information about common conditions of prematurity, equipment found on the NICU and a NICU reference guide can be found on the March of Dimes website.
Adjusted/Corrected Age — The baby’s chronological age plus the number of weeks of gestation. Ex: on January 17, Ike and Molly were eight weeks old (eight weeks since they were born), but their adjusted age was 32 weeks gestation, as they should still have been in utero. The development of premature babies is evaluated based on their adjusted age, not their chronological age.
Aminophylline — a medicine used to stimulate the heart and dilate air passages.
Anemia — a condition where a baby is not producing enough red blood cells. Frequent blood tests on the NICU can contribute to anemia.
Ambu bag — a bulbous apparatus attached to a breathing mask or endotracheal tube to provide manual ventilation to a patient.
Amphotericin — an antifungal and antibiotic.
Apnea/apnea of prematurity — irregular breathing patterns or breathing interruptions lasting 5-20 seconds.
Arm board — a small padded board used to keep the baby’s arm still so it will not dislodge an IV.
ASD/Atrial Septal Defect — a congenital heart defect that is a hole in the wall (septum) that divides the two upper chambers of the heart, which prevents blood from circulating properly and makes the heart work harder than normal.
Ativan — a sedative used to calm an agitated preemie so he or she does not burn too many calories or dislodge equipment.
Bagging — ventilating the lungs using a hand-squeezed bag attached to a mask or ET tube.
Bili lights — phototherapy using bright blue fluorescent lights to help the body break down and eliminate bilirubin.
Bilirubin — a yellow pigmented waste product in the blood formed when old red blood cells break down.
Blood gases — the combination of dissolved oxygen and carbon dioxide found in the blood. Blood gas analysis is done often on a preemie to determine how much oxygen and carbon dioxide is present, as well as the pH or acidity level of the blood.
Bradycardia — slow heart rate; in a preemie, this means lower than 100 beats per minute. A premature baby’s heart normally beats 120-160 per minute.
Bronchopulmonary dysplasia/BPD — a chronic lung problem often found in premature babies who require prolonged mechanical ventilation. The ventilator can cause lung damage and leave behind scar tissue that results in this chronic lung disease.
Bronchospasm — a lung spasm where the bronchial muscles constrict the air passages.
Cannula/nasal cannula — a plastic tube with two small prongs that are inserted into the nose to deliver extra oxygen.
cc — cubic centimeter, a measure of volume. Five ccs equal one teaspoon.
Central line — An intravenous line inserted into a vein and threaded into a larger vein close to the heart. It is used to deliver medications and nutritional supplements that may irritate a smaller vein.
C-PAP — continuous positive airway pressure, delivery of air to a baby’s lungs through small tubes in the baby’s nose or through a tube inserted into the windpipe. It is attached to a ventilator to help the baby breathe, but does not breathe for him or her.
Creatinine — a waste product produced by muscles; creatinine levels in the blood are used to measure kidney function.
Culture — examining a blood sample to check for infection; cultures are often placed in a special medium in the laboratory and grown for several days.
Desatting — see oxygen saturation.
Dexamethasone — a medication used to improve lung function to help wean a premature baby off of mechanical ventilation.
Dextrose — a glucose (sugar) solution administered intravenously to provide nutrients.
DPT (now DTaP) vaccine — diphtheria-pertussis-tetanus vaccine
Echocardiogram/echo — a specialized ultrasound used to visualize the heart.
Edema — an abnormal accumulation of excess fluids in the body.
Endotracheal tube/ET — small plastic tube inserted through a baby’s mouth into the trachea (windpipe), often attached to an ambu bag or ventilator.
Extubate — to remove the endotracheal tube.
Failure to thrive — inadequate physical growth diagnosed by observation of growth over time using a standard growth chart
Fentanyl — a narcotic used as both a sedative and a pain reliever.
Gavage feeding — feeding through a tube placed in the nose (nasogastric or NG tube) or mouth and down into the stomach. Preemies who are ventilated often get gavage feedings, as well as those who are very small and don’t have enough coordination to suck and swallow.
Glucose levels — blood sugar levels.
Gram — a unit for measuring mass; there are 454 grams to a pound.
Gram negative rod infection — bacteria classified by the color they turn when subjected to a certain stain; gram-negative rod bacteria turn pink or lose color.
Hyperal — parenteral hyperalimentation; solution of protein, sugar, minerals and vitamins provided through an IV to premature babies who are unable to get breast milk or formula, often because their digestive systems are too immature.
Indocin — a medication used to close a PDA (see PDA)
Intubate — to insert an endotracheal tube.
Isolette/incubator — a clear plastic box that serves as the baby’s bed while he or she needs help maintaining body temperature and to protect the baby from germs and noise. It usually has arm holes with doors that can be opened so doctors and nurses can administer to the baby.
IV/Intravenous line — a small needle or tube inserted into a baby’s vein to deliver blood, medications, nutrients and fluids.
Jaundice — evidenced by a yellowing of the eyes and skin, jaundice is caused by a buildup of bilirubin, which is broken down by the liver. A preemie’s liver is often too immature to keep up, resulting in jaundice.
Lasix — a diuretic used to treat edema, an excess accumulation of fluid.
Lipids/Intralipids — a solution of fats administered intravenously to provide nutrients.
Lung disease — see bronchopulmondary dysplasia.
Mucomyst — a drug used to loosen and thin mucous in the airways, making it easier to clear the mucous and easing breathing. Used in patients with cystic fibrosis and other chronic lung conditions.
Nasogastric/NG tube — tube threaded through the nose and sinuses down into the stomach or intestines to provide give feedings to babies who cannot suck and swallow, or who burn off too many calories during bottle (nipple) feedings.
NEC/Necrotizing enterocolitis — a serious intestinal infection found in preemies; the lining of the immature intestine is injured, allowing bacteria from the digestive tract to enter the blood stream and causing infection.
Neonatologist — a pediatrician with advanced training in treating the health problems of newborns, specifically high-risk situations such as prematurity, serious illness, injury, or birth defects.
Ohio bed — a trade name for an open radiant warming table that allows complete access to the baby by doctors and nurses. Babies in an Ohio bed are too sick to be in an incubator or open crib.
Oxygen hood — a small, clear plastic box placed over the baby to provide extra oxygen. For larger babies, the hood is placed over the head. For preemies, the hood is often placed over the entire baby.
Oxygen levels/Os — the amount of oxygen added to room air to improve oxygen saturation.
Oxygen saturation — the amount of oxygen bound to hemoglobin in the blood; normal is 100 percent. “Desatting” refers to conditions when the oxygen saturations levels are going down.
Pavulon — a paralytic drug used to help stabilize premature babies whose own breathing and movements can interfere with ventilation.
PDA/Patent ductus arteriosus — the most common heart problem in premature babies.The ductus arteriosus is a short blood vessel in the fetus that connects the pulmonary artery with the aorta. While in utereo, most of the fetus’s blood goes through this vessel and bypasses the lungs because the fetus gets its oxygen supply from its mother. This ductus usually closes by itself just before, during or after birth. If it remains open, it is called a patent (open) ductus arteriosus or PDA.
PIA/Positive inotropic agent — medication that increases the force of cardiac muscle.
Pulse oximeter — a light sensor placed around the baby’s foot or hand to measure blood oxygen levels.
Respiratory Distress Syndrome/RDS — a serious breathing problem sometimes called hyaline membrane disease, often found in preemies due to a lack of surfactant in the lungs
Respirator — see ventilator.
Retractions — visible sinking in of the chest wall while breathing in, found in babies with respiratory difficulty.
Room air — the air we normally breathe, which contains 21 percent oxygen.
Retinopathy of prematurity/ROP — abnormal growth of blood vessels in the eye in babies born before 32 weeks of pregnancy. ROP can damage the retina and cause vision damage or even blindness.
Retrolental fibroplasia — see retinopathy of prematurity.
Saturation, sats, satting — see oxygen saturation.
Spinal tap/LP/lumbar puncture — a procedure used to draw spinal fluid to test it for infection.
Surfactant — a substance with a soapy consistency produced by the lungs to provide lubrication and maintain the elasticity of delicate air sacs.
Terbutaline — a bronchodilator drug used to relax the bronchial muscles and expand the bronchial air passages.
Ventilator — a machine that provides warmed and humidified air to the baby’s lung, sometimes also breathing for the baby. Oxygen level, rate of delivery (number of breaths per minute), and the pressure at which the air is delivered are all adjusted independently to meet the baby’s breathing needs.
Ventilator rates — the number of times per minute the ventilator pushes air into the lungs.
VLBW — very low birth weight, less than 1,500 grams (3 pounds, 4 ounces)