Glossary of Common NICU Terms

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P

Parenteral Nutrition (Hyperalimentation)
Solution put directly into the bloodstream, giving necessary nutrients, such as protein, carbohydrates, vitamins, minerals, salts, and fat. Other names for this are hyperal, total parenteral nutrition (TPN) and intravenous feedings.
Patent Ductus Arteriosus (PDA)
The ductus arteriosus is a blood vessel connecting the pulmonary artery and the aorta. Before birth, this vessel allows the baby's blood to bypass the lungs because oxygen is supplied by the mother through the placenta. The ductus arteriosus should close soon after birth. If it does not, it is called a patent (open) ductus arteriosus, or PDA. A PDA may be treated either with medication or surgery.
Periodic Breathing
Irregular breathing pattern marked by pauses for as long as 10 to 20 seconds. This is common in both premature and full-term babies and does not usually mean there is a problem.
Periventricular Leukomalacia (PVL)
Within our brains are two small fluid-filled areas called ventricles. Cerebrospinal fluid is made within these ventricles. Periventricular tissue is just to the right and left sides of the ventricles. The tissue gets its blood supply from the arteries just before the arteries narrow down into capillaries. If the periventricular tissue does not receive an adequate blood supply, the tissue may die. When the tissue dies, it leaves fluid in its place, which appears as a cyst.
The cysts themselves are not a problem, but they represent brain tissue that has died and been replaced by fluid. PVL is the appearance of these cysts on an ultrasound, CT, or MRI scan of the head. The brain tissue that has been lost is important to the control of muscle movements in the legs and sometimes in the arms. PVL is often associated with cerebral palsy and other developmental problems.
Persistent Pulmonary Hypertension of the Newborn (PPHN)
High blood pressure in the lungs, which causes the small blood vessels in the lungs to become progressively narrower. It can lead to breathing problems and reduced levels of oxygen in the blood. Sometimes treated with nitric oxide, a gas naturally produced by the body that can help expand blood vessels.
Phototherapy
Light therapy to treat jaundice. Bright blue fluorescent lights, called bililights, are placed over the baby's incubator. Treatment usually lasts between 3-7 days.
PICC Line
A special IV line used to provide fluids into a vein. A PICC line is usually very stable and lasts longer than a typical IV.
Pneumogram
A sleep study, monitoring the baby's breathing and heart rate during sleep to detect any abnormal breathing patterns.
Pneumothorax
When air from the baby's lungs leaks out into the space between the baby's lungs and chest wall. While small leaks may cause no problems and require no treatment, larger leaks may cause serious complications such as lung collapse and may need to be repaired with surgery.
Premature Baby
A baby born three or more weeks before the due date.
Pulmonary Interstitial Emphysema (PIE)
A condition occurring in infants on ventilators that results in the formation of "bubbles" around the tiny air sacs (the alveoli) of the lungs. These "bubbles" may interfere with normal lung function.

R

Respiratory Distress Syndrome (RDS)
Respiratory problems due to lung immaturity. Respiratory distress is a much more inclusive term meaning simply that the child is having problems breathing. Respiratory distress syndrome is a specific condition that causes respiratory distress in newborn babies due to the absence of surfactant in the lungs. Without surfactant, the alveoli (air sacs) collapse when the baby breathes out. These collapsed air sacs can only be reopened with increased work at breathing. Most newborn babies do not have a normal amount of surfactant in their air sacs until 34 to 36 weeks' gestation. However, some very premature infants (27 to 30 weeks' gestation) will have adequate surfactant production and function and some full-term infants (37 to 40 weeks' gestation) will not. For more information, read the RDS Fact Sheet provided by the American Lung Association®.
Respiratory Syncytial Virus (RSV)
The most common cause of bronchiolitis in young children. Bronchiolitis is an infection of the bronchial tubes that causes rapid breathing, coughing, wheezing and sometimes, even respiratory failure, especially in the first two years of life. RSV infection and bronchiolitis is a particular risk for infants with chronic lung problems and those born prematurely.
The RSV season is usually from October to March. For more information, visit the MedImmune website.
Retinopathy of Prematurity (ROP)
Scars and abnormal growth of the blood vessels in the retina, the layer of cells in the back of the eye. The retina does not mature until close to term (40 weeks gestation), so when babies are born very prematurely, the normal growth of blood vessels into the retina is altered. These abnormally growing vessels can eventually lead to disruption of the retina and the loss of eye function.
Fortunately, severe ROP is unusual and mostly found in extremely premature infants. Routine exams for ROP will be given to premature infants at risk starting at about the 5th or 6th week after birth. If severe ROP develops, there are treatments that can reduce or prevent the loss of vision. For more information and a detailed explanation of ROP, you can visit the site of The Association for Retinopathy of Prematurity and Related Diseases (ROPARD).
Retraction
An abnormal sucking in of the chest during breathing, indicating that the baby is working too hard to breathe.
Retrolental Fibroplasia (RLF)
An old name for retinopathy of prematurity.
Room Air
The air we normally breathe, which contains 21% oxygen. When supplemental oxygen is given for respiratory problems, it is in concentrations higher than 21%.
Rooting Reflex
An instinctive reflex in newborn infants that causes them to turn their head to the side when their cheek is stroked. This reflex helps infants learn how to eat. By gently stroking the cheek, your baby will turn his or her head toward you with an open mouth ready to feed.

S

Sats
Term for blood oxygen saturation.
Seizure
A "short-circuiting" of electrical impulses in the brain, resulting from a variety of causes. Seizures can generally be classified as either "simple" (no change in level of consciousness) or "complex" (when there is a change in consciousness). Seizures may also be classified as "generalized" (the baby's whole body is affected) or "focal" (only one part or side of the body is affected).
Sepsis
A potentially dangerous infection of the bloodstream which occurs when the body's normal reaction to inflammation or a bacterial infection goes into overdrive. Certain lab tests, cultures, and x-rays can help diagnose this condition, which is treated with antibiotics. Also known as Systemic Inflammatory Response Syndrome (SIRS).
Septicaemia is sepsis of the bloodstream caused by bacteremia, which is the presence of bacteria in the bloodstream, but this term is also sometimes used to refer to sepsis in general.
Small for Gestational Age (SGA)
A baby whose birth weight is less than the normal range for the gestational age. You can read more about SGA in this Factsheet from the Lucile Packard Children's Hospital at Stanford.
Social Worker
Trained professional who helps coordinate social services available to families and also helps families understand and use their insurance coverage. They can help families access services available through governmental and private agencies. Some social workers also act as counselors for parents undergoing personal or family stress while their baby in a NICU.
Sonogram
Another name for an ultrasound.
Step-down Unit
Babies can be transferred from the NICU to this unit to continue their recovery after they are no longer acutely ill.
Surfactant
Surfactant is a soapy material inside the lungs of adults and mature infants that helps the lung to function. Without surfactant, the air sacs tend to collapse on exhalation. Lung surfactant production is one of the last systems to mature in an infant, which can cause the breathing problems found in preemies.
Fortunately, surfactant obtained from cows has been shown to be safe and effective in treating respiratory distress due to surfactant deficiency. The use of surfactant to treat respiratory problems in preemies is one of the most important recent medical advances in pediatrics.
Swaddling
Securely wrapping a baby in a light blanket to soothe and/or restrain him or her. The NICU nurses can teach you how to swaddle your baby.
Synchronized Intermittent Mandatory Ventilation (SIMV)
The ventilator mode where the mechanical breaths given by the ventilator are synchronized with the baby's spontaneous (regular) breaths.
Synchronizer
Small, soft sensor attached to the infant's abdomen and certain types of ventilators that tell the ventilator when the infant is taking a breath. It helps to match ventilator support with the infant's own breathing efforts. When the baby starts to take a breath, the synchronizer triggers the ventilator to provide a ventilator breath to the infant. Other types of ventilators use sensors near the breathing tube to sense when the child is breathing in.

T

Tachycardia
A faster than normal heart rate.
Tachypnea
A faster than normal respiratory rate.
Theophylline
A medication used to stimulate an infant's central nervous system. It is prescribed to reduce the incidence of apneic episodes. Thi is the "oral" form that can be ingested by an infant through a nipple or feeding tube. The intravenous form is known as Aminophylline.
Tone
Passive resistance to movement of the extremities is called tone. Normally infants give only a moderate amount of resistance to you when you move their extremities. The amount of tone present is one way of assessing the condition of the nervous and muscular system in an infant.
Infants with too much tone, too much resistance to passive movement, are called hypertonic and an extreme example of this is spasticity. Infants with too little tone (too little resistance to passive movement) are called hypotonic. In many cases, hypotonia can mean simply low muscle tone and increased flexibility or laxity of ligaments; in one who is severely ill it can mean an inability to sit up, crawl, walk, or eat correctly.
Tonic Neck Reflex
A newborn reflex that resembles a fencing position. When your infant's head is turned to the side, one arm will straighten, the opposite arm will bend, and often one knee will significantly bend. You won't see this if your baby is crying and this reaction usually disappears between 5 to 7 months of age. Infants vary in the degree to which this reflex is obvious.
Transient Tachypnea of the Newborn (TTNB)
Fast breathing that slowly becomes normal. It is thought to be caused by slow or delayed reabsorption of fetal lung fluid, and is more common in babies delivered by cesarean delivery and in those who are slightly preterm.

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