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NICU glossary

We use many medical terms in the NICU. Here are some you may come across during your stay with us; you are always welcome to ask questions about anything you hear.

ANEMIA - a low number of red blood cells in the blood. NICU babies are not always able to make red blood cells quickly enough to replace the ones lost when blood is taken from them for testing.

ANTIBIOTICS - a type of medication used to treat a suspected or actual bacterial infection. Until the specific bacterium is identified, babies receive combination antibiotics to treat them for the most "common" types of infections.

APGAR SCORE - a number given at one and five minutes of age that measures the baby's condition based on heart rate, breathing, muscle tone, activity level and colour.

APNEA - the premature baby has an immature brain, and this means he/she may occasionally forget to breathe. Premature babies may then require stimulation (a gentle rub on the back) to remind them. This is common for premature babies and usually subsides by 34-35 weeks, as their brain matures.

ARTERY - blood vessels that carry oxygen-rich blood away from the heart and lungs to the body's organs and tissues. Arteries are also the blood vessels that are used to feel the pulse or measure the body's blood pressure.

ASPIRATE - breastmilk or formula that is left in the baby's stomach from the previous feeding. Assessing the presence and amount of aspirate helps guide the nurse when deciding whether or not the baby is ready to have his or her feeding volume increased.

ASPIRATION - the direct result of inhaling any foreign matter into the lungs.

BAGGING - a special way to give babies oxygen and/ or extra breaths using an air filled bag.

BILIRUBIN - a product of the breakdown of red blood cells, filtered out of the blood by the liver. The prema­ture baby's liver is immature and therefore does not filter as well as it should. This causes the bilirubin to build up in the blood resulting in jaundice (a yellow/ orange hue to the skin).

BLOOD GAS - a sample of blood that measures the level of oxygen, carbon dioxide and acid (pH) in the blood. It is used to measure how well your baby is ventilating and or breathing.

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, 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

BPD (BRONCHOPULMONARY DYSPLASIA) - is a form of chronic lung disease that occurs most often in babies who are very premature. 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.

BRADYCARDIA (BRADY) - any decrease in the baby's heart rate below 100 beats per minute that lasts longer than 15 seconds and requires stimulation to correct. It is frequently associated with apnea (see above) and happens less often as the baby matures.

BREAST PUMP - an electric machine used by nursing mothers to express milk from their breasts.

CARBON DIOXIDE - the gas we breathe out as a waste product.

CBC (COMPLETE BLOOD COUNT) - a blood test done for several reasons, including to determine if an infection may be present and to see whether or not the baby is anemic (see anemia, above).

CENTRAL LINE - a special IV catheter used to give fluid, medication or nutrition to the baby; includes long lines or PICCs and UVCs. It can stay in for an extended time period, if needed.

CHEST TUBE - a tube surgically inserted through the baby's chest wall into the space around the lungs to reopen a partially or totally collapsed lung. (See pneumothorax).

CORRECTED AGE - the age of a baby from the due date, not the birth date.

CPAP (CONTINUOUS POSITIVE AIRWAY PRESSURE) - is a type of respiratory support used to deliver con­stant air pressure into a baby's nose, which helps the air sacs in the lungs stay open and helps prevent apnea.

CYANOSIS - dusky, bluish color of the skin, lips, and nail beds caused by having too little oxygen in the blood.

DESATURATION (DESATS) - when the oxygen level in the blood falls below the set value on the saturation monitor. Acceptable levels of oxygen vary depending upon the baby's age, and the monitor alarm limits are set accordingly.

DIP - when the heart rate drops below 100 beats per minute and comes up quickly without requiring any stimulation.

DONOR HUMAN BREASTMILK - this is Expressed Breastmilk donated by healthy mothers. This milk is pasteurized making it safe and is used as the preferred alternative to formula feeding in the very premature baby until a mother's own milk is available.

EBM (EXPRESSED BREAST MILK) - milk that mothers express using a breast pump or hand expression. This milk can be used soon after it is pumped, or it can be frozen and saved for later use.

ECG - a machine that is attached to a baby's chest in order to do a printed read-out of his heart beat. This may be done when a murmur is heard.

ECHOCARDIOGRAM - an ultrasound of the heart, usually performed by the cardiologist.

EDEMA - also known as "puffiness"; this is swelling due to extra fluid under the skin.

ETT (ENDOTRACHEAL TUBE) - a soft plastic tube placed into the baby's mouth or nose and into the windpipe (trachea) to help with breathing.

FORTIFIER - human milk fortifier is a powdered substance added to breast milk to give it extra calories and minerals such as calcium and phosphorous.

GESTATIONAL AGE - the number of weeks a woman is pregnant; the age at which a baby is born.

GLUCOSE - a type of sugar in the blood. Different types of glucose monitoring are done but the most common is done using a glucometer at the bedside.

GLYCERIN TIP - also known as a "silver bullet" because of its packaging. Occasionally a very small tip of a glycerin suppository is used to help babies pass stool.

HEART MONITOR - this monitor shows the heartbeat on a special computer screen. Three gelled electrodes (leads) sit on the baby's skin. An alarm rings if the readings are not within the normal limits. False alarms are common and usually happen when the baby wiggles or a lead falls off.

HEEL STICK - a method of getting blood from a baby's heel

HYPOGLYCEMIA - low blood sugar.

HYPOXEMIA - when not enough oxygen is flowing in the blood.

INTERSTITIAL - refers to an IV that is no longer in the vein and must be restarted.

INCUBATOR - a heated and humidified bed specifically for babies in the NICU. The incubator is often referred to by the manufacturer's name - Drager®.

INTRAVENOUS (IV) - a small catheter placed a short distance into a vein to provide fluid and or medications. Babies can have IV's in their scalp, hands, arms, legs, or feet. These sites are rotated regularly.

INTRAVENTRICULAR HEMORRHAGE (IVH) - is bleeding into the fluid-filled areas (ventricles) surrounded by the brain.

IUGR (INTRA-UTERINE GROWTH RESTRICTED) - when a baby's growth slows or ceases while it is in the uterus.

JAUNDICE (HYPERBILIRUBINEMIA) - the yellow color seen in the skin usually during the first 2 weeks of life, due to the buildup of broken down blood cells.

LAB WORK - this is a collective term for any blood samples that a baby may need taken from him.

LGA (LARGE FOR GESTATIONAL AGE) - a baby born who is larger than usual for those born at the same gestational age.

LIPIDS - a white, high calorie fat solution that is delivered by IV or mixed in with your infant's milk/formula.

LOW FLOW - refers to one of the many ways to deliver oxygen and/or air to babies. (See nasal prongs)

LONG LINE (PICC) - a long intravenous line placed further into a large vein using sterile technique. This line can be left in for long periods of time.

LUMBAR PUNCTURE - a small needle is placed in the baby's lower back using sterile technique to get a very small amount of spinal fluid for specialized testing.

LYTES (ELECTROLYTES) - the measurement of sodium, potassium, chloride in the baby's blood. The results of this test help the medical staff treat the baby.

MECONIUM - the first, thick black stools passed by a baby. These stools can last for several days and are thick and tar-like.

MURMUR - a "whooshing" sound of blood going through the heart and surrounding blood vessels. It is detected by using a stethoscope and listening to the heartbeat on the chest or back. Murmurs are common in premature babies. They can be a sign of a PDA (see below) or other heart problem, or they can be benign.

NASOGASTRIC TUBE / OROGASTRIC TUBE (NGT/OGT) - this tube is placed through the nose or mouth to the stomach and is secured with tape. It is a way to feed the baby and to release built up air and gas in the stomach.

NASAL PRONGS - small soft plastic prongs that are placed in the baby's nose to deliver oxygen or air.

NEC (NECROTIZING ENTEROCOLITIS) - a serious bowel condition that can arise unexpectedly in premature infants in the NICU. Babies with it can have bloating, blood in stools, and feeding intolerance; they can become very sick.

NEONATAL - the period of time from birth to 28 days.

NICU - Neonatal Intensive Care Unit.

NPO - nothing by mouth (not feeding)

NPT (NASAL PHARYNGEAL TUBE) - a short single breathing tube that goes to the back of the baby's nose and is attached to a ventilator so the baby can receive positive pressure air, or puffs of air to help him/her breathe.

OVERBED WARMER - a large warmer that can be placed over the opened door of an incubator to keep the baby warm during procedures.

OXYGEN - an odourless, colourless gas needed by all body cells. The air around us, also called 'room air,' is 21% oxygen. If needed, a baby can be given up to 100% oxygen.

PDA (PATENT DUCTUS ARTERIOSIS) - the ductus is a blood vessel that keeps the blood away from the lungs before a baby is born because the lungs are filled with fluid. Usually the ductus closes shortly after birth. If the ductus stays open (or patent) it may interfere with normal blood flow, heart and lung function. The PDA may be treated with medication or surgery if necessary. For more information, please go to: http://www.sickkids.ca/familyinformation/documents/ pda/PDAwebsite.html

PHOTOTHERAPY (BILI LIGHTS) - a special blue light used in the treatment of some types of jaundice. Eye shields are placed over the baby's eyes to protect them from the light.

PNEUMONIA - infection in the lungs.

PNEUMOTHORAX - a collection of air in the space between the lung and the chest wall, but outside the lung.

POST MATURE - a baby born after 42 weeks gestation.

PREMATURE - a baby born before 37 weeks gestation.

RESPIRATORY DISTRESS SYNDROME - the most common breathing problem found in premature babies. Because the baby may be too young to have developed an important substance called surfactant, the tiny air sacs in their lungs (alveoli) do not stay open easily, as they should. Without surfactant, the air sacs collapse and the baby cannot get enough air into his lungs to breathe effectively. Surfactant therapy sends surfactant down a tube into the lungs, which helps makes the lungs more flexible and eases ventilation.

ROOM AIR - refers to the concentration of oxygen in the air around us, which is 21 percent.

ROP (RETINOPATHY OF PREMATURITY) - abnormal growth of blood vessels in the eye that is most common in babies who were born very premature. Babies will have their eyes examined for ROP if they meet criteria, or on the advice of the medical team. Ask if your baby will be getting eye exams.

OXYGEN SATURATION (SAT) - a term that describes the amount of oxygen in the blood.

SATURATION ("SAT") MONITOR - a monitor that shows the amount of oxygen in the blood. The small monitor is placed around a baby's foot or hand/wrist and can be easily identified by the red light. The light does not produce heat.

SEPSIS - an infection that occurs in the blood. If there is any question that an infection may be developing, blood samples are drawn (culture, CBC) and antibiotics are started.

SEPTIC WORK-UP - includes blood drawn for CBC, and Blood Culture. If the baby is very ill the medical team may request that spinal fluid or urine be obtained and sent for culture.

SGA (SMALL FOR GESTATIONAL AGE) - when a baby's length, weight or head circumference is below the 10 percentile for that gestational age.

SPELL - a term that also describes a brady, apnea or a desat (see above).

SUPRAPUBIC TAP - a sterile specimen of urine obtained from a needle tap into the bladder.

TACHYCARDIA - a heart rate that is faster than the average range. The average range for premature babies is 120-160. A full term baby's heart rate would be slightly lower at 90-140 beats per minute.

TACHYPNEA - a breathing rate that is faster than the average range. Premature babies breathe at an average rate of 40-60 breaths per minute. Full term babies breathe at an average rate of 30-60 breaths per minute.

TPN (TOTAL PARENTERAL NUTRITION) - an IV solution (often yellow) that contains nutrients to help a baby grow. TPN is used when a baby is not able, or is just starting to feed.

TRANSFUSION - giving blood or blood products through an IV.

UAC (UMBILICAL ARTERY CATHETER) - a soft, clear catheter placed into one of the arteries in the umbilical cord. This is used to monitor BP, draw blood for testing, and give fluids. In very sick or premature babies this line is placed at birth using sterile technique.

UVC (UMBILICAL VENOUS CATHETER) - a soft, clear catheter placed into the vein in the umbilical cord. This line is used to give fluids and medications. In very sick or premature babies this line is placed at birth using sterile technique.

ULTRASOUND - a procedure that uses sound waves to produce a picture of the baby's internal organs. (I.e.: brain, heart, kidneys, liver etc.) A series of head ultrasounds are done on babies who meet criteria, or on the advice of the medical team. Ask if your baby is getting head ultrasounds.

UMBILICUS - the belly button or cord. This cord has three major vessels (one vein and two arteries) and is clamped at birth. Usually, this cord dries up and falls off after a short time. However, with premature babies, the umbilical vessels are used to insert arterial and venous catheters.

VEINS - blood vessels that carry blood from the rest of the body back to the lungs to be oxygenated.

VENTILATOR ('VENT') - a machine used to help a baby breathe. The machine connects to the ETT or NPT.

VENTRICLES (OF THE BRAIN) - spaces in the brain where spinal fluid circulates.

VERNIX - the thick white creamy substance that pro­tects the baby's skin inside the womb toward the end of pregnancy. Because premature babies are often born before their vernix has developed, they do not have this protective coating on their skin.

VITAL SIGNS - temperature, heart and breathing rate and blood pressure that are recorded on the baby's chart.

VITAMIN K - helps blood to clot normally; all babies receive one intramuscular injection at birth.

X-RAYS - a type of picture that shows the internal structures (bones and organs) of the body. In the NICU, x-rays are also used to help the health care team confirm the proper location of tubes or lines the baby may need. They are also used to check on the condition of the baby's heart, lungs and bowel.