When I was a new NICU nurse, I was so overwhelmed by the amount of medical "jargon" I needed to learn. And for parents, it can be especially intimidating and confusing. Here is a list of the most common terms used daily in the NICU setting and a short but (hopefully) helpful definition of each.
ABDOMINAL ULTRASOUND
Sound waves are used to produce a picture of the GI tract. The test is simple and painless and is often ordered to get more information about the liver or kidneys.
ALVEOLI
Tiny sacs in the lungs where oxygen and carbon dioxide from the air are exchanged in the bloodstream.
ANEMIA
A condition that occurs when there are less than the normal number of red blood cells in the blood.
ANTIBIOTICS
Medication that kills bacteria and stops/prevents an infection. Commonly used antibiotics in the NICU include ampicillin, gentamicin, ceftazidime, and vancomycin.
AORTA
The artery (large vessel) leading from the heart that moves oxygenated blood to the body.
ARTERY
Any blood vessel that leads away from the heart and carries oxygenated blood to the body.
APNEA & BRADYCARDIA
Apnea - The cessation of breathing for a short period of time (<20 seconds). This stop in breathing is often linked to a slower than normal heart rate AKA Bradycardia - heart rate <100 beats per minute.
ASPHYXIA
A condition where there has been a lack of sufficient oxygen to the tissues of the body. The brain and the kidneys are the most sensitive organs to a lack of oxygen.
ASPIRATION
Breathing/inhaling a foreign material (such as formula, breastmilk, stomach fluids, meconium, amniotic fluid, etc.) into the lungs.
BACTERIA
A one-celled organism that can use infections in the bloodstream, urine, spinal fluid, lungs, or intestines.
BAGGING
Filling the lungs with air or oxygen by squeezing a bag which is connected to an endotracheal tube or attached to a mask fitted over the face. This allows us to breathe for the baby when his own breaths are not enough.
BILI LIGHTS (Phototherapy)
Special lights used in the treatment of jaundice; see “Phototherapy and Hyperbilirubinemia”.
BILIRUBIN
A breakdown product of red blood cells. This is a test to check for jaundice by looking at the level of bilirubin in the blood. See “Phototherapy and Hyperbilirubinemia.”
BLOOD GASES (EPOC)
A test that measures the amount of oxygen, carbon dioxide and degree of acidity in the blood. A small amount of blood is taken from the heel (by heel stick), umbilical catheter or from the artery near the wrist where your pulse is felt to test for these levels. This helps assess how well the baby is breathing with or without oxygen support and indicates if any adjustments need to be made.
The pressure of the blood in the arteries with each pulsation of the heart. It measures the pressure the blood exerts against the walls of the blood vessels. This pressure causes blood to flow through the veins. It is measured in two numbers: systolic and diastolic.
BLOOD TRANSFUSION
This procedure puts blood or blood products from a donor into your baby’s blood. The donor blood comes from a blood bank and has been tested to make sure it is as safe as possible for your baby. The most common reason that a baby may need a blood transfusion is due to anemia. The neonatologist will discuss the procedure with you first and obtain consent before starting any blood products.
BRADYCARDIA
An abnormally slow heart rate.
BRONCHOPULMONARY DYSPLASIA (BPD)
Also known as chronic lung disease. This is lung damage in a baby who is treated with oxygen and mechanical ventilation for a long period of time.
CAPILLARIES
Tiny blood vessels that come into close contact with the body’s cells and supply the cells with oxygen and nutrients.
CARBON DIOXIDE (CO2)
A waste product (not used by the body) created by breathing air. Carbon dioxide is carried by the blood to the lungs, where it is exhaled.
CARDIOPULMONARY/CARDIORESPIRATORY (CP/CR) MONITOR
A device that tracks your baby’s heart rate and breathing rate. The monitor is connected to your baby with electrodes or leads (sticky pads placed on your baby’s chest and abdomen, or sometimes limbs).
CBC (Complete Blood Count)
A count of the various types of cells present in the blood and helps to identify if a baby has an infection. Red cells (for carrying oxygen), white cells (for fighting infection), and platelets (for prevention of bleeding).
CCS (California Children's Services)
A state agency, operating by county, which assists with medical benefits and ongoing therapies for infants and children who meet certain diagnostic criteria.
CHEM PANEL (BMP, CMP)
A test to measure the levels of different electrolytes in the blood.
CHEMSTRIP
AKA Blood glucose check. This is a test in which a drop of the baby's blood is placed on a strip of special paper to determine the amount of sugar in the blood.
CHEST TUBE
A small plastic tube placed through the chest wall into the space between the lung and chest wall, or between the ribs and lungs. The tube drains extra fluid or air out of the chest to allow the baby’s lungs to expand so that he/she can breathe better.
CHEST X-RAY (CXR)
A painless way to take a picture of the inside of your baby’s chest allowing doctors to see the heart and lungs to help determine the cause of breathing problems.
CHRONOLOGIC AGE
A baby’s age based on his/her actual birthday.
CIRCUMCISION
A surgical procedure done to remove the foreskin of the penis. Usually done just before the baby goes home and only on request.
COLOSTRUM
The breast milk produced in the first few days after having a baby. This milk is especially rich in nutrients and antibodies.
CONGENITAL
Existing at the time of birth.
CORRECTED AGE
A baby’s age based on his/her gestation.
CPAP (Continuous Positive Airway Pressure)
A form of ventilator assistance which helps to keep the baby's lungs properly expanded as he/she breathes. CPAP does not breathe for the baby, but allows the baby to breathe into a "wind." This is pressurized air, delivered by a mask or nasal prongs, with or without extra oxygen.
C-Reactive Protein (CRP)
A protein that is higher when inflammation (swelling) is found in the body. A high level may be suggestive of an infection.
CT SCAN (of the head)
Computerized x-rays which show the size and position of many parts of the brain. A CT scan also can be done on other parts of the body. The baby must go to another area of the hospital to have a CT scan. A series of X-rays are taken from different angles and used by a computer to create detailed images.
CULTURE (Cx)
A laboratory test of blood, spinal fluid, urine, or other specimens which shows if germs are present and which ones they are. This helps to detect the location of an infection.
CYANOSIS
Blue color of the skin that occurs when there is not enough oxygen in the blood.
DESATURATION
A low level of oxygen in the blood, usually caused by an A/B spell.
DIFFERENTIAL
A test which divides the white blood cell count (from the CBC) into several categories, chiefly: "polys" (short for polymorphonuclear leukocytes), "bands" (immature "polys"), "lymphs" (lymphocytes), "monos" (monocytes), "cos" (eosinophils), "basos" (basophils). The percentages of each cell type may vary in different kinds of infections; for example, polys and bands usually will predominate in bacterial infections, while the number of lymphs usually will increase in viral infections.
DYSPNEA
Difficulty breathing.
ECHOCARDIOGRAM (ECHO)
A test performed to look at the heart using soundwaves through the chest wall. This is much like an ultrasound done during pregnancy and is neither harmful nor painful. This is used to identify heart defects and show how the heart is working.
EDEMA
Fluid retention/buildup in the body tissues that causes puffiness or swelling.
ENDOTRACHEAL TUBE (ETT)
A thin, plastic tube which goes from the baby's nose or mouth past the vocal cords and into the upper trachea (windpipe). This tube allows a breathing machine to directly deliver air and/or oxygen into the lungs.
EXCHANGE TRANSFUSION
A treatment which removes the baby's blood in small quantities and replaces it with donor blood. This procedure is used most frequently to lower the level of bilirubin in the baby's blood. (See also “Phototherapy and Hyperbilirubinemia.”) It also may be used to raise or lower the number of red blood cells, and improve the ability of the blood to clot.
EXTUBATION
The removal of a tube which has been placed through the nose or mouth into the trachea; see ENDOTRACHEAL TUBE.
FEEDING TUBE (NG/OG/GT)
Feedings that are given through a tube that passes through the nose or mouth to reach the stomach. Medications can also be delivered through the tube. A GT (gastrostomy tube) is placed directly into the stomach and sits on top of the baby’s abdomen.
FUNDOPLICATION
A surgery to wrap the upper part of the baby’s stomach around the lower part of the esophagus. This helps to reduce reflux if a baby is having constant emesis. This surgery is permanent and irreversible.
GASTROESOPHAGEAL REFLUX DISEASE
Occurs when milk is forced up backwards into the baby’s esophagus instead of down into the intestines. This can lead to choking from vomiting or spit-up, apnea and bradycardia, or even an oral aversion due to a negative association with bottle feeding. Treatment may include medication or possibly surgical correction.
GAVAGE FEEDINGS
Feedings delivered by a small plastic tube placed through the nose or mouth and down into the stomach when the baby is too weak or too premature to suck and swallow from a bottle.
GLUCOSE
The type of sugar that circulates in the blood and is used by the body for energy. A baby’s glucose level should not get too low (hypoglycemia) or too high (hyperglycemia) and will be monitored by the care team.
GRAM
A unit of measurement or a way to measure weight. Your nurse will typically tell you your baby’s weight in grams or kilograms. 454 grams equal one pound, and 1 kilogram equals 1000 grams.
HEEL STICK
A quick prick of the heel with a sterile instrument (much like a finger prick) to obtain small blood samples for tests.
HEMATOCRIT (crit)
A test done to determine if the amount of red blood cells in the blood is adequate.
HIGH FREQUENCY OSCILLATORY VENTILATOR (HFOV)
A special ventilator capable of breathing for your baby at higher rates than a normal ventilator, typically used if a baby requires more help than a typical ventilator can provide.
An abnormal accumulation of cerebrospinal fluid (the normal fluid which bathes the brain and spinal cord) in the ventricles of the brain. This can cause increased pressure inside the baby’s head indicative of a sharp-pitched cry (“neuro cry”).
A low amount of sugar (glucose) in the blood.
HYPOTENSION
When a baby’s blood pressure is low. Medications may or may not be necessary to treat the low blood pressure.
I:E RATIO
Inspiratory/expiratory ratio. The ratio of the length of the forced breath provided by a ventilator to the length of the time between two breaths.
INFILTRATION (IV Infiltrate)
The slipping of an IV needle out of a vein, allowing IV fluid to accumulate in the surrounding tissues.
INFUSION PUMP
A pump attached to an intravenous (IV) line that provides fluids/nutrition to your baby in measured amounts. The pump can also be attached to a feeding tube that provides milk to your baby.
INTRAVENOUS (IV)
A small plastic tube or hollow metal needle placed into one of the baby's veins, through which fluids, sugar, and minerals can be given when the baby cannot take all of his nourishment by feedings.
INSPIRATORY TIME (IT)
The length of a forced breath provided to the baby by a ventilator.
INTRAVENTRICULAR HEMORRHAGE (IVH)
A collection of blood in and around the ventricles (hollow portions) of the brain. Bleeding inside or around the ventricles in the brain can lead to brain damage. There are four grades (levels) of IVH:
Grade 1 - bleeding confined to the tiny area where it first begins
Grade 2 - blood is also within the ventricles
Grade 3 - more blood in the ventricles, usually with the ventricles increasing in size
Grade 4 - a collection of blood has moved within the brain tissue
INTUBATION
The process of inserting an endotracheal tube in the baby's trachea (windpipe). See Endotracheal Tube.
IUGR (INTRAUTERINE GROWTH RESTRICTION)
A phrase used to describe babies who are smaller than they should be for their gestational age. This is usually caused by very low levels of amniotic fluid in utero (oligohydramnios).
JAUNDICE
A yellow coloration of the skin and eyes caused by increased amounts of bilirubin in the blood. Bilirubin is a break-down product of red blood cells; it is processed and excreted by the liver. It is a common problem in newborn infants and usually occurs during the first week of life. Most cases are mild and may not require treatment. Treatment for jaundice includes phototherapy ("bili lights") and (rarely) exchange transfusion. See also “Phototherapy and Hyperbilirubinemia.”
KUB (Abdominal X-ray)
Stands for Kidney, Ureter, Bladder. This is a painless way to take a picture of the inside of your baby’s abdomen. This allows doctors to see the bowels to help determine the cause of feeding problems.
LABS
Most babies receive many blood or lab tests while in the NICU. These tests provide the care team with vital information about your baby’s condition. Most tests are performed using a heel stick, meaning your baby’s heel will be pricked with a small needle (lancet). Some specific labs require the nurse to draw blood from a vein in your baby’s arm, hand, scalp, foot, or leg.
LANUGO
The fine, downy, sometimes dark hair that covers the body of the fetus (baby before birth) from about the fourth or fifth month in the womb. This type of hair disappears as a baby reaches full term but is often present in preemies.
LUMBAR PUNCTURE ("Spinal Tap")
A procedure that tests for an infection in the spinal fluid or to measure the amount of pressure in the spinal canal. A small needle is carefully placed in the small of the back, between the vertebrae (back bones), to obtain spinal fluid for bacterial cultures and other tests.
MECONIUM
The first bowel movements that a baby has which are thick, sticky, tarry, and dark green-to-black in color.
MAS (Meconium Aspiration Syndrome)
The inhalation of meconium into the lungs. If a baby stools in the womb and the stool contaminates the amniotic fluid, the meconium may be inhaled into the lungs, causing significant problems with breathing after the baby is born.
MENINGITIS
Infection of the fluid that cushions and surrounds the brain and spinal cord.
MRI (Magnetic Resonance Imaging)
A machine that uses a large magnet, radio frequencies, and a computer to create very detailed pictures of your baby’s brain. All metal must be removed from around the baby. The baby must go to another area of the hospital to have an MRI. Sedation may be needed prior because your baby must stay completely still during the test. It provides a more detailed picture than a head ultrasound.
MURMUR
An extra heart sound that may (or may not) be a sign of heart problems. A murmur is often heard with a patent—or open—ductus arteriosus (PDA). However, some murmurs are normal. A murmur is typically heard with a stethoscope
NASAL CANNULA
A soft, clear, plastic tube which passes under the nose to provide supplemental oxygen/air.
NECROTIZING ENTEROCOLITIS (NEC)
An infection of the wall of the intestines, which may spread to the blood. Premature babies are particularly vulnerable to this disease. NEC is a very serious condition that can be life threatening. Surgery is sometimes necessary to remove damaged intestines, and the baby may need prolonged feeding by vein until he recovers.
NEONATOLOGY
The medical specialty concerned with diseases of newborn infants (neonates). Neonatologists are pediatricians who have received several years of additional training.
NEWBORN SCREEN (NBS)
A screening for specific genetic diseases in the following groups: metabolic, endocrine, hemoglobin, or other genetic diseases. It is performed within the first three days of the baby’s life, and is MANDATED by the state!
NPO
Nothing by mouth is a term meaning to withhold food and fluids. It is also known as nil per os, a Latin phrase that literally translates to English as "nothing through the mouth.”
OXYGEN SATURATION MONITOR (AKA Pulse Oximetry)
A small probe placed on the finger, hand, wrist, toe, or foot of your baby that painlessly measures the oxygen level in the blood.
PAIN MEDICATION
Your baby’s care team is closely watching for signs and symptoms of pain. If they believe your baby is in pain, they will start with nonpharmacologic measures first to comfort them; these include rocking, holding, swaddling, repositioning, distracting (mobile or music box), or giving your baby a pacifier. Examples of pain medications commonly given in the NICU include morphine, methadone, fentanyl, ativan, and versed.
PARENTERAL NUTRITION (TPN)
AKA Total Parenteral Nutrition. This is a fluid that contains protein and sometimes fats (lipids) given along with sugars and salts by vein when the baby cannot tolerate complete feedings by nipple or gavage.
PATENT DUCTUS ARTERIOSUS (PDA)
A small vessel which allows blood to bypass the lungs. This vessel is open while the baby is in the womb, but normally closes shortly after delivery. If the vessel fails to close on its own, special medication or surgery may be needed. If it stays patent, it can cause stress to the baby’s heart and lungs over time. See also “Let’s Talk: PDA.”
PEAK INSPIRATORY PRESSURE (PIP)
The highest pressure that is delivered to the baby by the ventilator during a forced breath.
PERIVENTRICULAR LEUKOMALACIA (PVL)
Injury to the white matter (inner part of the brain), usually caused by infection, low oxygen levels, or low blood pressures. This can lead to cerebral palsy and other problems.
PHOTOTHERAPY
A treatment in which the baby is placed under bright lights (frequently blue in color) or on a special light blanket which helps bilirubin to be excreted into the intestine. The light breaks down the bilirubin in the blood so it’s easier for your baby’s body to get rid of it. The nurse will cover the baby’s eyes with a mask to protect them from the bright lights. See also “Phototherapy and Hyperbilirubinemia.”
PICC LINE
A type of central line/central catheter that stands for Peripherally Inserted Central Catheter. A thin, flexible tube is placed in a large vein to deliver medications or necessary fluids and nutrients to the body. PICC lines are usually threaded through a vein in the arm to the vena cava. These types of catheters are indicated when IV therapy, antibiotics, or TPN/Lipids are administered for a long period of time OR if your baby is a really hard stick (has fragile veins that collapse) and a peripheral IV is unable to be inserted.
PKU (Phenylketonuria)
A rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood. Babies with PKU require a special diet. All babies are routinely tested for PKU, as well as several other disorders, before going home from the nursery. This test is required by law.
PNEUMOMEDIASTINUM
Leakage of air from the normal passageways of the lung into the space surrounding the heart inside the chest. A pneumomediastinum is usually harmless in itself, but is often associated with a pneumothorax (which can be life-threatening if large). See PNEUMOTHORAX.
PNEUMOTHORAX
Leakage of air from the normal passageways of the lung and is trapped in the space surrounding the lung inside the chest wall, causing a partial or complete collapse of the lung. This condition may require a chest tube.
POSITIVE END-EXPIRATORY PRESSURE (PEEP)
The lowest pressure that is delivered by the ventilator to the baby between forced breaths.
PROGNOSIS
The outcome that is expected in the future.
PULMONARY HYPERTENSION
Caused when the baby has difficulty pumping blood to the lungs. This limits oxygen entering the baby’s bloodstream and causes the heart to work harder.
PULMONARY INTERSTITIAL EMPHYSEMA (PIE):
Caused when pressure from a ventilator leaks air from the lungs, creating tiny air bubbles that get trapped between the layers of the lungs.
RED BLOOD CELLS (RBCs)
The cells in the blood which carry oxygen.
REFLUX
A return or backward flow; gastroesophageal (GE) reflux occurs when portions of feedings or other stomach contents flow back up into the esophagus. See also: “GASTROINTESTINAL REFLUX DISEASE.”
REGIONAL CENTER
One of a network of state-funded agencies which helps to coordinate community services and resources to infants at risk of having a developmental delay; also provides services and coordination of resources to children and adults with specific developmental disabilities.
RESIDUAL
The contents left inside a baby’s stomach at the starting of the next feeding.
RESPIRATORY DISTRESS SYNDROME (RDS)
A common breathing problem of premature infants caused by insufficient surfactant (a lubricating fluid) in the baby's lung. This results in an excessive stiffness of the baby's lungs and difficulty breathing.
RETINOPATHY OF PREMATURITY (ROP)
A condition of the eye that causes blood vessels to grow abnormally in the retina. Vessels that help the retina develop are one of the last parts of the eye to mature (several weeks after the baby’s due date). Supplemental oxygenation over a long period of time can increase the baby’s risk of developing ROP. Severe cases can lead to significant vision loss, detachment of the retina or blindness. See also “Retinopathy of Prematurity.”
RETRACTIONS
A sign of respiratory distress and that your baby is having trouble breathing. This appears when the chest wall pulls in as the baby uses muscles to breathe. It is often associated with grunting, nasal flaring, and head bobbing.
SEDATION
A medication given to help a baby remain calm, quiet, relaxed, or immobile. Babies may require sedation if they are on a ventilator, have a chest tube, are going for a procedure, have a possible brain injury, etc. They will be gradually weaned off the medication as their condition permits.
SEIZURE
A "short circuiting" of the electrical activity in the brain, sometimes causing involuntary muscle activity or stiffening. There are many causes of seizures. If your child has a seizure, speak with your baby's doctor about this condition and its implications.
SEPSIS
Infection of the blood that affects the baby’s whole body. Sepsis is treated with antibiotics and can be life-threatening if not treated early.
SEPTIC WORKUP
An assortment of tests performed on an infant who is suspected of having an infection. This may include a chest x-ray and/or abdominal x-ray, as well as blood, urine, and spinal fluid cultures. Because infections in babies can progress very rapidly, the baby is frequently started on antibiotics until the results of the cultures are known.
SUCTIONING
The process of removing mucus out of the baby’s mouth, nose, or endotracheal tube through the use of a suction catheter (small tube), neosucker (suction device), or bulb syringe.
SURFACTANT
A material secreted by special cells within the alveoli (air sacs) of the lung, which makes the lung flexible and helps to keep the lung from collapsing. Deficiency of surfactant is the main problem in RDS. Commercial products are available which can be put into the lungs through the tube in the windpipe. These products frequently are very helpful to the premature baby with RDS.
SWALLOW STUDY
A test used to see if the baby can swallow safely and effectively.
SYNCHRONIZED INSPIRATORY POSITIVE AIRWAY PRESSURE (SIPAP)
CPAP with additional higher pressure settings for babies who need more help and support than CPAP can offer.
TACHYCARDIA
An abnormally fast heart rate that is greater than 180 beats per minute.
TACHYPNEA
An abnormally fast rate of breathing (respiratory rate) that is greater than 60 breaths per minute.
TERM INFANT (Full-Term Infant)
A baby born between 37 and 42 weeks gestation.
TRACHEOSTOMY
A surgical opening in the trachea, below the larynx (voice box) to allow air to enter the lungs; usually done to by-pass a narrowing in the area immediately below the larynx.
TRANSFUSION
Giving donated blood to the baby by vein or artery.
ULTRASOUND OF THE HEAD (Cerebral Ultrasound)
A test performed using soundwaves which shows an image of the brain. The test is not harmful or painful to the baby and may be done at the bedside.
UMBILICAL CATHETER
A small, flexible, plastic tube placed in one of the umbilical (belly button) blood vessels (either an artery or a vein).
VEIN
A blood vessel leading to the heart that carries non-oxygenated blood from the body.
VENTILATOR
Sometimes referred to as a breathing machine or respirator. A special machine connected to an endotracheal tube to help your baby breath by giving breaths and oxygen.
VENTRICULAR SEPTAL DEFECT (VSD)
A hole between the two lower chambers (ventricles) of the heart
VITAL SIGNS
A set of numbers that are obtained every hour in the NICU. These include temperature, breathing rate, heart rate, blood pressure, and oxygen saturation. Nurses are constantly monitoring these numbers and assessing trends. If any become abnormal they will intervene accordingly and take the appropriate/necessary steps.
WEANING
To take away gradually, often used to describe the process of removing a baby from a ventilator or incubator, or from specific medications (for drips, it may be referred to as titrating).