As and Bs

Periods of apnea and bradycardia (slower breathing and slower heart rate. (See apnea & bradycardia)

Acidosis

A condition in which there is high level of acid in the bloodstream. Respiratory acidosis is caused by a high level of carbon dioxide while metabolic acidosis is due to depletion of buffers or accumulation of acids. A baby may also have mixed acidosis due to a combination of respiratory and metabolic causes.

Adjusted Age

A baby’s age based on their gestational age at birth combined with their chronological age. (see corrected age)

Anemia

A condition in which the red blood cells measured by hematocrit (the ratio of the volume of red blood cells to the total volume of blood), are lower than normal. Red blood cells carry oxygen and carbon dioxide to and from the tissue.

Apnea

A prolonged pause in breathing that lasts more than twenty seconds. This is a common problem in premature infants and requires monitoring and sometimes medication.

Aspiration

Inhaling a foreign substance into the lungs, such as milk or amniotic fluid.

Bagging

To pump air into the baby’s lungs using oxygen and a rubber bag. This method is used temporarily for a baby who needs help breathing.

Bethamethasone

A steroid medication given to the mother before birth to help the baby’s lungs mature more quickly. It is most effective if given more than 24 hours before delivery. Betamethasone also helps the brain, intestines, kidneys, and other systems to mature.

Blow by

To give a baby a small amount of oxygen through a tube pointed towards the nose.

Bilirubin

A yellow-pigmented chemical that is a natural waste product formed when the body naturally eliminates old red blood cells. 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 a high level accumulates, it may make the skin and eyes look yellow, a condition called jaundice. In premature infants, they’re often put under blue light or on a bili blanket to help the levels come down. (See phototherapy)

Blood Gas: ABG/Arterial Blood Gas

A blood test used to evaluate an infant’s level of acid, oxygen, carbon dioxide, and bicarbonate. This helps to evaluate an infant’s respiratory status and if they need more oxygen, less oxygen or ventilator setting changes.

Blood Pressure

A measure of the force of blood moving through blood vessels. Can be taken periodically using a cuff that is placed around the baby’s arm or leg, or it can be monitored continuously using special equipment called a transducer that is connected to the umbilical artery catheter (UAC) inserted into your baby’s umbilical cord.

Blood Test

Blood tests may seem frequent, but they check many things to help keep baby healthy. These include but are not limited to: glucose levels, electrolyte levels, hemoglobin, hematocrit, bilirubin, infection.

Blood Urea Nitrogen — BUN

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

Bolus

A single dose of medication given at once or over a short time. Bolus can also refer to feeds given over about 15-30 minutes, as opposed to continuous feeds.

Bradycardia (Brady):

A slowing of the baby’s heart to a low rate, often associated with apnea. (see As & Bs)

Bronchopulmonary Dysplasia — BPD

A form of chronic lung disease (CLD) — respiratory distress in preemies who’ve been treated with oxygen and mechanical ventilation. Babies with BPD have inflammation and scarring in the lungs. Many infants with BPD recover and improve with time, achieving normal or near normal function.

Caffeine Citrate (Cafcit®)

A central nervous system stimulant that’s used to treat certain breathing problems.

Cardiorespiratory or Cardiopulmonary Monitor

A monitor used to measure a baby’s heart rate and respiratory breathing rate. Three small sticky pads, or “leads,” are placed on a baby’s chest and belly. Each pad or disk has a wire attached to the monitor. The monitor is then able to determine the baby’s heart rate and respiratory rate. A siren will sound if the rates become too fast or too slow.

CBC — Complete Blood Count

Blood test done for several reasons, such as checking if an infection may be present or to see if the baby is anemic.

Central Line — Central Venous Line CVL/Central Venous Catheter CVD

Special IV catheter used to give fluid, medication or nutrition to the baby; includes long lines or PICCs and UVCs. The line is placed in a major vein of the body during surgery or by insertion through a vein in the arm, leg, or head. It can stay in for an extended period of time, if needed.

Cerebral Palsy — CP

Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by abnormalities in one or more specific areas of the brain, during, shortly after birth or during infancy which effect motor areas in the brain disrupting the brain’s ability to adequately control movement and posture.

“Cerebral” refers to the brain and “palsy” to muscle weakness/poor control.

Cerebrospinal Fluid — CSF

Fluid (produced by the ventricles of the brain) that circulates around the spinal column and brain.

Charge Nurse

The registered nurse who has general responsibility for coordinating the nursing care of all babies in a unit for a particular shift. Nursing shifts may be either 8 or 12 hours.

Chem strip (blood sugar or dex stick)

Testing of the baby’s blood sugar level.

Chest Tube

Tube surgically inserted through the baby’s chest wall into the space around the lungs to reopen a partially or totally collapsed lung.

Chronological Age

A baby’s age based on their actual birthday.

Continuous Feed

When baby is fed through a tube with a continuous drip, as opposed to bolus feeds.

Continuous Positive Airway Pressure — CPAP

Respiratory support — supplemental oxygen or room air — used to deliver con­stant air 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, which helps the air sacs in the lungs stay open and helps prevent apnea. The baby is technically breathing on his or her own.

Bubble CPAP

Bubble CPAP is a particularly effective method of generating CPAP pressure by directing gas flow past the baby’s airway into a column of water. (See CPAP — Continuous Positive Airway Pressure)

Corrected Age

A baby’s age based on their gestational age at birth combined with their chronological age. (Also adjusted age)

Culture

A laboratory test on blood or other body fluid to check for the presence of infection.

CXR

Chest x-ray

Cyanosis

Bluish coloration of the skin, lips or nails that happens when there is not enough oxygen in the blood. Acrocyanosis, bluish discoloration of the hands and feet, is often a normal finding during the first few days of life.

DC

Discontinued; medication that is no longer given.

Desaturation — Desat

A drop of oxygen levels in the baby’s bloodstream.

Developmentally Delayed

A term used to describe infants and toddlers who have not achieved skills and abilities which are expected to be mastered by children of the same age. Delays can be in any of the following areas: physical, social, emotional, intellectual, speech and language and/or adaptive development (sometimes called self-help skills). Many developmental delays can be overcome with early intervention programs.

DOL

Day of Life. The day that a baby is born is day zero. (There are a few NICUs that start with Day 1.)

Early Intervention Program

Planned use of physical therapy and other interventions in the first few years of a child’s life to enhance the child’s development.

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.

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.

Electrolytes

Electrolytes are minerals in your blood and other body fluids that carry an electric charge. They affect how your body functions in many ways. Checking electrolyte levels usually includes sodium, potassium, chloride, calcium, and phosphate.

Emesis

Vomit

Endotracheal Tube — ETT or ET Tube

A tube that passes through either the baby’s mouth or nose into the windpipe (trachea) to allow oxygen into the lungs.

Enteral Nutrition

Feeding delivered by tube. There are a few types.

Extubation

See Intubation

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. severe respiratory failure).

Febrile

With a fever or caused by fever. Afebrile is without fever.

G Tube — Gastrostomy Tube

A gastrostomy tube is surgically placed to give direct access to your child’s stomach for supplemental feeding, hydration or medicine. There are different types.

Gavage Feedings

Providing nutrition through a plastic tube passed through the baby’s mouth or nose and into the stomach. See NG and OG.

Gastroesophageal Reflux — GER

Contents on the stomach coming back up into the esophagus, which occurs when the junction between the esophagus and the stomach is not completely developed or is abnormal. GER is very common among preemies. Mild forms of GER are common. GER becomes GERD, gastroesophageal reflux disease, in the setting of complications such as aspiration or irritation of the lining of the esophagus and cause a form of heartburn” which causes them to become irritable and uncomfortable.

Gestational Age

Age of baby in weeks, starting from the beginning of pregnancy.

Glucose

Sugar in the blood used for energy.

Gram — GM, gm, G

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

Head Ultrasound (HUS)

A painless test that uses sound waves to look at a baby’s brain. This test can be done at the bedside in the NICU.

Hearing Screen

Test to examine the hearing of a newborn infant. All newborn infants born in the United States have a hearing screen to be sure they are able to hear.

Heart Murmur

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

Heel Stick

Pricking the baby’s heel to obtain a blood sample for testing.

Hemoglobin (cHb)

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

Hematocrit (Hct)

This test measures the proportion of red blood cells in the blood.

H & H

Blood test for hemoglobin and hematocrit.

High Flow

A form of non-invasive respiratory support that provides heated, humidified oxygen gas at rates greater than 2 litres per minute. Some NICUs use high flow as an alternative to CPAP.

HFV — High-Frequency Ventilator

A machine that gives hundreds of tiny breaths per minute.

High-Frequency Oscillatory Ventilator — Oscillator

A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator (for example, 300 – 900 BPM, or Breaths Per Minute).

High-Frequency Jet Ventilator

A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator (300-420 BPM, or Breaths Per Minute).

Hyaline Membrane Disease — HMD

Another name for respiratory distress syndrome — RDS.

Hydrocephalus

Abnormal accumulation of cerebrospinal fluid within the ventricles of the brain. It is sometimes known as “water on the brain.”

Hypotension

Low blood pressure.

Idiopathic

Something which happens spontaneously or from an unknown cause.

Ileal Perforation

Puncture 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. (Some NICUs have reported success by putting drainage tubing into the abdomen to allow material to drain and let the perforation seal on its own.)

IMV — Intermittent Mandatory Ventilation

A way to help babies breathe using a ventilator to give a set number of breaths per minute.

Indomethacin

A drug sometimes given to close a patent ductus arteriosus. (see PDA)

Intravenous (IV)

IV = given by vein. Nutrition or medication given through a catheter that is inserted into a vein. 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 or to administer surfactant. (Extubation indicates the removal of this tube.)

Is and Os — Intake (Input) & Output

The amount of fluid, (IV and feeds) baby takes in compared to how much the baby excretes in urine and stools.

Isolette or Incubator

A type of enclosed heated bed for an infant who is not mature or well enough to maintain body temperature in an open crib.

Intraventricular Hemorrhage — IVH — “Brain Bleed”

Bleeding into the ventricles (fluid-filled spaces) within the brain. There are two small structures, the choroid plexus, within the fluid filled ventricles in the brain that manufacture cerebrospinal fluid. The areas just outside of those ventricles are the periventricular white matter. Adjacent to the outer wall of the ventricle is the germinal matrix, an area of immature nerve cells and tender blood vessels. As the preterm baby matures, brain cells from the germinal matrix migrate outward to form the outer layers of the brain, and the germinal matrix gradually disappears.

The tender blood vessels within the germinal matrix can rupture and bleed; this is called a germinal matrix hemorrhage or grade I intraventricular hemorrhage (IVH). The bleeding, if more extensive, can enter the ventricle itself, a grade II IVH. If the cerebrospinal fluid is unable to circulate normally, the ventricles can become enlarged and, which is a grade III IVH. If bleeding either involves or secondarily injures the periventricular brain tissue, it is a grade IV IVH or IVH with hemorrhage into the brain substance outside of the ventricular system.

Intracranial Hemorrhage

Bleeding within the skull. Bleeding most often occurs within the ventricles of premature infants, but it can occur anywhere within or on the outside of the brain.

Intrauterine Growth Restriction — IUGR

A condition in which the fetus doesn’t grow as much as it should while in the uterus. IUGR can be caused by decreased blood flow to the placenta, maternal hypertension, preeclampsia, multiple fetuses, abnormalities of the cord or placenta, chromosomal abnormalities, and other causes.

Jaundice

A yellow skin color that develops in most premature babies and in some full-term babies, due to high bilirubin levels. (see Bilirubin)

Kangaroo care

Skin-to-skin care where the baby is placed on the bare chest of the mother or father.

Lanugo

The fine, downy hair that often covers the shoulders, back, forehead, and cheeks of a prematurely born newborn. Lanugo is replaced by more normal appearing hair toward the end of gestation.

Leads

Monitor wires attached to sensors on baby’s skin.

Lumbar Puncture — LP or Spinal Tap

A test in which a small needle is used to remove sample fluid from around the spinal column (between two lumbar vertebrae).

Magnetic Resonance Imaging (MRI)

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

Meconium

A dark green sticky substance found in the baby’s intestines. It’s the first bowel movement after birth. Passage of meconium within the uterus before birth can be a sign of fetal distress. The meconium is very irritating to the lungs.

Meconium Aspiration Syndrome — MAS

Respiratory disease caused when babies inhale meconium or meconium-stained amniotic fluid into their lungs; characterized by mild to severe respiratory distress.

Metric System Conversions

100 grams is about 3.5 ounces.
1 kilogram is about 2.2 pounds.
1 milliliter is about .03 fluid ounces.

Monitor

A machine that displays the heart rate, respiratory rate, blood pressure and blood oxygen saturation of the baby.

Moro Reflex

A newborn reflex. The automatic response to loud noises or sudden movements in which a newborn will extend his arms and legs, arch its back, and sometimes cry out. Newborns can have this reaction even during sleep, but lose it after a few months.

Motor Skills

Gross motor skills are the movements that use the large muscles in the arms, legs, and torso, such as running and jumping. Fine motor skills are the small muscle movements used to grasp and manipulate objects, like picking up a Cheerio or using a crayon.

Nasal Cannula

Small prongs, connected to plastic tubing, that are placed in the baby’s nose to deliver supplemental oxygen.

Nasal SIMV

A form of noninvasive respiratory support that combines a continuous positive end-expiratory airway pressure (PEEP) with intermittent higher pressures delivered by a nasal mask or nasal prongs.

Necrotizing Enterocolitis — NEC

Necrotizing enterocolitis (NEC) is a serious gastrointestinal illness of unknown cause that occurs primarily in preterm newborns. The disease is characterized by intestinal inflammation. Human milk feedings may provide some degree of prevention.

NG Tube — Nasogastric Tube

A feeding tube that goes through the nose to the stomach.

Nirsevimab (Beyfortus)

Is a form of monoclonal antibody that helps to prevent RSV. It is not a vaccine.

Non-Invasive Blood Pressure Monitor

A machine connected to a small blood pressure cuff wrapped around your baby’s arm or leg. The cuff takes your baby’s blood pressure at regular times and displays it on a screen. Blood pressure is the force of blood that pushes against the walls of the arteries.

OG Tube — Orogastric Tube

A feeding tube that goes through the mouth and into the stomach.

Opti-Flow

A brand of heated, humidified, high flow respiratory support delivered by nasal cannula.

Oxygen Saturation

Oxygen saturation measures the amount of oxygen carried by the hemoglobin in red blood cells.

Patent Ductus Arteriosus — PDA

Persistence of a fetal vessel that connects the pulmonary artery and aorta. This vessel generally closes by itself but may remain open, particularly in preterm babies, allowing excessive blood flow to the lungs. If the vessel does not close spontaneously, it may be closed with medication, a transcatheter plug, or with a surgical clip.

Persistent Pulmonary Hypertension — PPHN

When a newborn’s circulation system doesn’t adapt to breathing outside the womb and retains features of the fetal circulation, the baby’s oxygen supply may be affected.

Phototherapy

Light therapy to treat jaundice. Bright blue lights, called bili-lights, are placed over the baby’s incubator or the baby may be placed on a blanket that will shine the light up towards the baby. A protective eye shield is usually placed over the baby’s eyes.

PICC

Peripherally inserted central catheter (PICC) or percutaneous central venous catheter (PCVC) is a type of tube that is put into a central (large) vein. (See Central Line)

PKU – Metabolic Screen/Newborn Screening

A blood test done on special paper that tests for several different genetic disorders. It’s often done within 24-72 hours after birth and repeated on preemie babies at various intervals.

Pneumothorax

Pneumothorax — also called a collapsed lung — may cause more difficulty with breathing and affect blood contents and pressure. It often involves inserting a needle or chest tube between the ribs to remove the excess air. Smaller ones may heal on their own and require less intervention.

PO / NPO

Per os / oral (PO), means by mouth. NPO, nil per os, means nothing by mouth. (They are Latin terms)

Priming the Gut

Used to describe the slow start of feeds to get the digestive system ready to function fully (also called trophic feeds).

PRN (Latin — pro re nata)

As needed/necessary.

Pulse Oximeter — “Pulse-Ox”

A machine that measures how well the blood is being oxygenated using sensors attached to the hand, wrist, and/or foot.

PVL — Periventricular Leukomalacia

PVL is a type of brain injury to the white matter around the fluid-filled ventricles of the brain. Babies with PVL have a higher risk of developing cerebral palsy. PVL symptoms, usually characterized by especially tight, contracted muscles, may not be apparent until later months.

Q

Indicates frequency, so q4H would mean every four hours.

Reflux

A backward flow of stomach contents, generally referring to a type of spitting up or regurgitation common in premature infants.

Respiratory Distress Syndrome — RDS

Lung disease that is caused by lack of surfactant (bubble-forming agent in the lungs) and is a common cause of breathing difficulty in premature babies.

Residuals

The contents remaining in the stomach at the start of a next feeding.

Respiratory Syncytial Virus — RSV

A common respiratory virus that typically causes mild, cold-like symptoms but can cause very serious illness, particularly in preterm infants.

Retinopathy of Prematurity (ROP)

An eye disease that affects preterm babies caused by the growth of abnormal blood vessels in the retina. Most cases improve without therapy, but some babies may require injections or laser treatment to preserve vision.

Room Air

The air that we breathe, with an oxygen concentration of 21% (at sea level).

Sedation

If your baby is on a ventilator or has a chest tube in place, he may require a sedative — a medicine that will keep your baby calm. The amount of sedation your baby needs will depend on his condition. Sedation medicine will be weaned gradually as your baby’s condition permits.

Sepsis

A dangerous and potentially fatal condition in which the body is fighting a severe infection that has spread via the bloodstream.

Spinal Tap/Lumbar Puncture (LP)

A procedure in which a needle is inserted into the lower spine to obtain spinal fluid.

Step Down Nursery / Special Care Nursery / Feeders & Growers Unit / Continuing Care Nursery

As it sounds, this nursery is a step down from the intensive care nursery. The move signals progress.

Suctioning

The process of removing secretions from the baby’s nose, mouth or lungs by using either a bulb syringe or suction catheter.

Surfactant

Surfactant is a liquid produced by the lungs that keeps the airways (alveoli) open, making it possible for babies to breathe in air after delivery. Babies at high risk for developing RDS (under 28 weeks gestation) are often given surfactant in the NICU.

Swallow Study – OPMS

Pediatric swallow studies — which are called oral pharyngeal motility studies (OPMS) — help to more clearly see any complications a child has during swallowing, such as food going into the lungs instead of the stomach (which may not cause them to cough — known as silent aspiration), food or liquid residue, and reflux (or silent reflux, where the food doesn’t come all the way up).

Synagis

Synagis is a shot of antibodies to help protect babies from RSV. While it is still available, a new product, Nirsevimab (Beyfortus), has been introduced.

Synchronized Intermittent Mandatory Ventilation (SIMV)

IMV timed with the baby’s breaths.

Tachycardia

A fast heart rate.

Tachypnea

A fast breathing rate.

Temperature Sticker

A sticker, often a gold mylar heart, that secures a temperature sensor to the baby’s body.

Thrombocytopenia

Thrombocytopenia is a condition in which there are too few platelets — the cells produced in the bone marrow — that are needed for clotting.

Tongue Tie (Ankyloglossia) / Lip Tie

These are conditions that are present at birth. A tongue tie is a short, thick or tight band of tissue (lingual frenulum) that tethers the bottom of the tongue’s tip to the floor of the mouth, so it may interfere with feeding and speech. A lip tie is an extra short or tight piece of tissue attaching your baby’s upper lip to their gum.

A small procedure may be necessary to correct, but it often does not need intervention and sometimes causes no problems at all. Recently, doctors (based on research) have reduced the frequency of these procedures; unless a serious issue is present, in many cases these ties can be left alone without any consequences.

Total Parenteral Nutrition (TPN)

A type of IV fluid that provides total nutrition to someone who cannot take any nourishment through the digestive tract. TPN is nutrition outside of the digestive system. TPN contains sugars, electrolytes, vitamins, proteins, and can supply all the nutrients that the body needs. (IL – intralipids)

TPR

Temperature, pulse, respiration

Tracheostomy Tube

A tracheostomy tube is an artificial airway inserted into the trachea (windpipe) through a surgically-created opening in the neck.

UAC — Umbilical Arterial Catheter

A tube put into an artery through the stump of the umbilical cord.

UVC — Umbilical Venous Catheter

A tube put into a vein through the stump of the umbilical cord.

Ventilator or Vent

A machine that helps an infant breathe by pumping oxygen into a tube (called an ET tube) that goes into the lungs.

VS — Vital Signs

Temperature, pulse, respiration (breathing), and blood pressure.

Warmer

Also known as a radiant warmer, an open bed that allows maximum access to a sick or newborn infant. Radiant heaters above the bed keep the baby warm.

Wean

To take away gradually. In the NICU, it’s often used to describe the process of removing an infant from a ventilator, incubator or tube feeding.