Understanding Neonatal Intensive Care
Neonatal intensive care describes the high level of care administered to premature infants or those infants with severe or potentially life-threatening conditions.
The neonatal intensive care unit, often shortened to NICU and sometimes pronounced “Nickyou,” is a unit of the hospital specializing in this type of care.
Introduced more than 50 years ago, neonatal intensive care provides these infants with better temperature support, higher levels of state-of-the-art technology, isolation from infection risk and specialized care. A typical neonatal intensive care unit provides a staff of neonatologists, neonatal nurses, pediatric hospitalists and a variety of other specialists and equipment ranging from incubators to continuous positive airway pressure (CPAP) to ventilators. Access is limited due to risk of infection.
A Level 3 NICU is the designation given to a center that cares for infants needing the highest level of attention and that employs state-of-the-art technology and resources.
WellStar Resources & Support
WellStar operates two Level 3 neonatal intensive care units (NICUs), one at The Family Birthplace at WellStar Cobb Hospital (20 beds) and another at The Jean & Mack Henderson Women’s Center at Kennestone Hospital (24 beds).
These units are among the few in the nation that offer parents special rooms and suites – WellStar deems them “The NICU Nests” – designed to provide privacy as they build familial bonds yet under the close and careful observation of highly trained staffs. Even though neonatal intensive care limits visiting time with these babies, WellStar’s NICUs and programs enable parents to spend as much quality time as possible with their children.
Even after your baby is discharged, WellStar maintains its circle of care with education, neonatal resources and ongoing support for the child, the new parents and the family.
Tests and Procedures
During your child’s stay at one of WellStar’s neonatal intensive care units, you can expect a number of tests, equipment and procedures designed to improve your infant’s well-being and ongoing health. These may include:
Neonatal Incubator, Infant Warmer or Isolette
An incubator, infant warmer or isolette is an apparatus designed to maintain the optimal environmental conditions for newborn babies, who often have difficulty maintaining their body temperatures. They may be described as enclosed, plastic bassinets with climate control.
These devices perform a number of functions, such as protection from cold temperatures, infection, noise, drafts and excess handling and allow ease of observation for monitoring temperature, respiration, cardiac function, oxygenation and brain activity. These devices also have access for feeding, fluid intake, waste disposal and medicinal tasks.
Intravenous (IV) Catheter and Line
An intravenous catheter (IV) is a thin, flexible tube inserted into the baby’s vein with a small needle. Once in the vein, the needle is removed and the tube remains to allow the administration of fluids and medications.
Most babies in neonatal intensive care require the use of an IV for fluids and medications. The IV is usually placed in the hands and arms, but sometimes may be placed in the feet, legs or scalp. In the first few hours after delivery, the IV may be inserted through the baby’s umbilical cord without using a needle.
An IV allows your WellStar neonatal intensive care staff to administer certain medications in a continuous fashion, several drops at a time, instead of giving an injection every few hours. These are called drips or infusions.
When larger tubes become necessary for greater volumes of fluids or medications, a specially trained pediatric surgeon will insert the IV. These are called central lines because they must be inserted into larger veins found in the chest, neck or groin.
Special lines called arterial lines are similar to IVs but are inserted into the arteries to monitor oxygen levels and blood pressure. But some babies may only require blood pressure cuffs instead.
When babies cannot consume enough calories through a bottle or breastfeeding, neonatal nurses may attach a feeding tube to provide them with formula or breast milk. The feeding tubes should not be painful to your baby as they are taped in place to prevent them from moving around. If feeding tubes are used extensively, they are replaced routinely so they won’t rub into the baby’s stomach or nose.
Infants in neonatal intensive care require constant monitoring, so the neonatal nurses can be kept constantly aware of their vital signs and comfort. The nurses attach a single monitor to your baby with chest leads, which are small painless stickers attached with wires, as well as a blood pressure cuff. The system keeps record of your baby’s heart rate, breathing rate, pulse, blood oxygen levels and temperature.
If your baby has jaundice, a common condition in newborns in which the skin and whites of the eyes turn yellow, the neonatal intensive care staff might employ phototherapy. In this procedure, a special light therapy blanket or lights attached to their beds or incubators help get rid of bilirubin that causes jaundice. This process usually only takes a few days.
When babies in the neonatal intensive care unit need additional help to breathe, they may be connected to a ventilator or some other breathing device such as continuous positive airway pressure (CPAP). When this is the case, physicians use an endotracheal tube, a plastic device placed into the windpipe through the mouth or nose.
For infants who need breathing assistance over an extended period of time, they may have a tracheostomy, in which the tube is placed directly into the trachea and then connected to a breathing device.
Decades ago, many pre-term babies died because of respiratory distress syndrome or RDS because their lungs would become brittle and collapse soon after their birth. Scientists discovered that pulmonary surfactant, a natural soapy substance created by special cells in the lungs’ alveoli, helped maintain the proper pressure in the lungs; many pre-term babies lack this substance.
Surfactant therapy introduces an artificial surfactant into the trachea and lungs of affected pre-term babies. Such therapy has reduced infant fatalities due to the disease from 10,000 a year to less than a 1,000.