Neonatal Intensive Care Units (NICUs) are equipped with complex machines and monitoring
devices designed for the unique needs of tiny babies. As a new parent, it can be overwhelming.
Learning about what to expect in the NICU can help ease your anxieties.
In the NICU, there are mechanical ventilators (breathing machines), oxygen, medications,
and supplies for medical care. There is also technology to monitor nearly every system
of a baby's body including body temperature, heart rate, breathing, oxygen and carbon
dioxide levels, and blood pressure. The following list includes some of the equipment
often used in the NICU:
Heart or cardiorespiratory monitor. This monitor displays a baby's heart and breathing
rates and patterns on a screen. Wires from the monitor are attached to adhesive patches
on the skin of the baby's chest, and abdomen.
Blood pressure monitor. Blood pressure is measured using a small cuff placed around
the baby's upper arm or leg. Periodically, a blood pressure monitor pumps up the cuff
and measures the level of blood pressure. Some babies need continuous blood pressure
monitoring. This can be done using a catheter (small tube) in one of the baby's arteries.
Temperature. A temperature probe is placed on the baby's skin with an adhesive patch.
A wire connects the temperature probe to the overhead warmer (or incubator) to help
regulate the heat needed to keep the baby warm.
Pulse oximeter. This machine measures the amount of oxygen in the baby's blood through
the skin. A tiny light is taped to the baby's foot or hand. A wire connects the light
to the monitor where it displays the oxygen saturation or "sat." This refers to the
percentage of hemoglobin in the baby's red blood cells that is saturated with oxygen.
X-ray. Portable X-ray machines may be brought to the baby's bedside in the NICU. X-rays
use invisible electromagnetic energy beams to produce images of internal tissues,
bones, and organs on film. X-rays are taken for many reasons including checking the
placement of catheters and other tubes, looking for signs of lung problems, such as
respiratory distress syndrome or pneumothorax, and checking for signs of bowel problems.
Computed tomography (also called CT or CAT scan). A CT scan is a diagnostic imaging
procedure that uses a combination of X-rays and computer technology to produce horizontal,
or axial, images (often called slices) of the body. A CT scan shows detailed images
of any part of the body, including the bones, muscles, fat, and organs. CT scans are
more detailed than general X-rays. CT scans are sometimes done to assess bleeding
inside a baby's head. A CT scan is done in a special room and the baby may need a
sedative medication so that he or she will be motionless for the exam.
Magnetic resonance imaging (MRI). MRI is a diagnostic procedure that uses a combination
of a large magnet, radio frequencies, and a computer to produce detailed images of
organs and structures within the body. Like a CT scan, MRI is performed in a special
area of the hospital. It is often done to examine a baby's brain stem, spinal cord,
and soft tissues. The baby will need a sedative medication so that he or she will
be motionless for the exam.
Endotracheal tube (ET). This tube is placed through the baby's mouth or nose into
the trachea (windpipe). The ET tube is held in place with special tape and connects
to a mechanical ventilator (breathing machine) with flexible tubing. An X-ray is used
to check the tube's placement. When a baby has an ET tube, he or she is unable to
make sounds or cry.
Respirator or mechanical ventilator. This machine helps babies who can not breathe
on their own or who need help taking bigger breaths. High frequency ventilators give
hundreds of very fast puffs of air to help keep a baby's airways open. Ventilators
can also deliver extra oxygen to the baby.
Continuous positive airway pressure (CPAP). Through small tubes that fit into the
baby's nostrils, called nasal CPAP, this machine pushes a continuous flow of air to
the airways to help keep tiny air passages in the lungs open. CPAP can deliver extra
oxygen as well. It may also be given through an ET tube.
Extracorporeal membrane oxygenation (ECMO). This is a special treatment for babies
with respiratory disease that does not respond to maximum medical care. With ECMO,
blood from the baby's vein is pumped through an artificial lung where oxygen is added
and carbon dioxide is removed. The blood is then returned back to the baby. ECMO is
only used in specialized NICUs.