Neonatal Intensive Care Unit (NICU): Equipment
Walking into a neonatal intensive care unit with all its machinery can be an alarming experience. Knowing more about the equipment in the NICU will help ease your discomfort as you come to appreciate the technology that helps support your little one. This alphabetized equipment list is designed to do just that.
Equipment in the NICU
Apnea monitor. An instrument that checks for stoppages in breathing (apnea). Many premature babies have episodes of apnea. If your baby has not completely outgrown it, she may temporarily need a monitor in the NICU, step-down unit, or at home. Connected to your baby by a soft belt that goes around her chest, the monitor will sound an alarm if she stops breathing or if her heartbeat is too fast or too slow. You will need to use the monitor when your baby is sleeping or when you are not watching her.
Arterial line ("art line"). A plastic catheter most commonly placed in an artery in the baby's wrist, ankle, or umbilical cord to allow for frequent measurement of blood-gas balance and blood pressure.
Bililights. Bright blue fluorescent lights placed over or around a baby to treat jaundice. NICU babies with jaundice usually receive this treatment, called phototherapy.
Blood pressure monitor. A machine connected to a small cuff wrapped around the baby's arm or leg. The cuff will automatically take your baby's blood pressure at regular times and display the numbers on a screen. The nurse may also take it manually.
Cardiopulmonary monitor. A device that tracks your baby's heart and breathing rates. Connected to your baby by small, adhesive pads placed on her chest, it shows information on a display screen and can also print onto paper. Some machines have additional displays for blood pressure or blood-gas measurements. If your baby's heart or breathing rate becomes too fast or too slow, an alarm will sound. However, loose connections can lead to false alarms. Some NICU hospitals will send infants home with a simplified model of this machine.
CPAP (continuous positive airway pressure). A process by which air is delivered to a baby's lungs, either through small tubes in her nose or through a tube that has been inserted into her windpipe. The tubes are attached to a ventilator, which helps the baby breathe, but does not breathe for her. This device prevents airway sacs from collapsing after each breath.
Central line. An intravenous line usually inserted into a vein in the arm, and threaded from there into a larger vein close to the heart. It is used to deliver medicine or nutritional solutions that would irritate smaller veins. A percutaneous intravenous central catheter (PICC) is a type of central line that is placed in one of the major blood vessels. A Hickman or a Broviac catheter, another type of central line, is inserted into the jugular vein in the neck.
Endotracheal (ET) tube. A small, plastic tube inserted through a baby's nose or mouth down into the trachea (windpipe). When this is put in place, the baby is said to be intubated. The tube is attached to a ventilator (respirator), which can help a baby breathe (as in CPAP) or breathe for her. The machine delivers a specific gas mixture at a specific rate and pressure to the infant. When the need for respiratory support lessens, the ET tube will come out, whereupon the baby is said to be extubated.
ECMO (extracorporeal membrane oxygenator). A machine that bypasses the lungs and performs gas exchange in the infant's blood until damage to her lungs or heart can heal or be repaired.
Feeding tube and syringe. Equipment that allows parents to perform gavage, or tube feeding, at home. Some babies are not able to take in enough food by mouth, including those with birth defects involving the heart, lungs, mouth, esophagus, or airway. So, formula or breast milk is fed, via syringe, into a tube placed in the stomach through the mouth. If a baby is not be able to take in enough food by mouth for an extended period of time, she may need to be fed through an opening in her stomach (gastrostomy) to which a small plastic feeding tube has been attached.
Incubator or isolette. A clear, plastic box that keeps babies warm and protects them from germs and some noise. When they are more mature and can maintain their body temperature better, infants are moved from a baby incubator to an open, plastic box, or a bassinet without a cover.
Intravenous (IV) line. A tube carrying nutrients into a baby's vein. Most premature and sick babies cannot be fed immediately, so they must receive nutrients and fluids intravenously. A doctor or nurse will insert a very small needle or plastic tube into a fine vein in your baby's hand, foot, arm, leg, or scalp. The needle is taped in place and attached to a plastic tube that goes to an IV pump, often connected to a pole next to your baby's bed. Your baby also can receive medications and blood through the IV line.
Nasal cannula or nasal prongs. Small, plastic tubes that fit into your baby's nostrils and deliver oxygen. They often are used in connection with CPAP treatment.
Nebulizer. A device attached to an ET tube or a mask to deliver vaporized fluids and medications to the baby's airway.
Oxygen. Babies generally are breathing on their own before they go home. But some need additional oxygen for a while. The most common reason is a lung disorder called bronchopulmonary dysplasia (BPD). If your baby requires oxygen, you will need an oxygen tank (there are several types) and nasal cannula that go around your baby's head. A home health nurse or respiratory therapist may visit on a regular basis to check on your baby. When the doctor decides your baby is breathing better, the amount of supplemental oxygen she receives will be gradually decreased, then discontinued.
Oxygen hood. A clear, plastic box that fits over the baby's head and supplies her with oxygen-enriched air. This is used for infants who can breathe on their own, but still need some extra oxygen.
Pulse oximeter. A small, U-shaped device that uses a light sensor to measure a baby's blood-oxygen level and heart rate. This painless device, which is wrapped around your baby's toe or hand, and secured with a stretchy bandage, allows for monitoring of blood oxygen without the need for frequent blood samples.
Radiant warmer (also called an open isolette). An open bed with an overhead heating source. An infant may be placed in a warmer instead of a baby incubator if she needs to be handled frequently, or while she is undergoing NICU monitoring procedures. A temperature sensor on the infant's skin allows the bed to adjust to her needs.
Umbilical catheter. Your baby's umbilical cord, with two arteries and one vein, allows access to her circulatory system for the first few days of life. A thin tube can be inserted into one of these arteries and threaded to the aorta. This is a UAC, or umbilical artery catheter. Through this catheter, doctors and nurses can painlessly draw blood without having to repeatedly stick the baby with needles. They can also use it to give her fluids, blood, nutrients, and medications. A small device can be attached to the catheter to continuously monitor your baby's blood pressure. The umbilical vein can also be used for infusion of fluids. This requires a UVC, or umbilical venous catheter.
Ventilator. A breathing machine (also called a respirator) that delivers warmed and humidified air to a baby's lungs. The sickest babies receive mechanical ventilation, meaning that the ventilator breathes for them while their lungs grow or recover. The air is delivered to the baby's lungs through an endotracheal tube. The amount of oxygen, air pressure, and number of breaths per minute can be regulated to meet each baby's needs. Those with serious breathing problems may be treated with a form of high-frequency ventilation, which delivers small amounts of air at a rapid rate. This treatment appears to help reduce complications (such as bronchopulmonary dysplasia) that can occur with mechanical ventilation.
What should I bring to the NICU?
Among all of these vital pieces of equipment, you might like to bring in some comfort measures. Ask your doctor if there’s anything specific you can bring in to help your little one feel more comfortable. Your doctors are experts who know how best to help preemies grow, develop, and feel at ease. Medical staff and nurses will be able to tell you when it’s time to bring in a warm beanie or a soft blanket that your baby can use during kangaroo care; how to choose the right clothes for preemies; and even how many preemie diapers to have on hand. You may feel overwhelmed by all the NICU equipment, and hospitals can sometimes feel sterile, but chat with NICU staff about how you can make the space a little more comfortable.
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