There are many different kinds of technology in the NICU, including different types of infant ventilators, monitors, and supportive devices, this section will explain the main types of equipment you may see in the NICU.

Equipment to Help Preemies Breath

When preemies are born early their lungs are often not developed enough for them to breath by themselves. Some preemies with need help for a couple of days, others need the most advanced support from a ventilator for several weeks and still others need them for months.

Extra oxygen & oxygen masks

This equipment is used if your baby can breathe by him/herself but needs some extra oxygen. Extra oxygen can be delivered straight into an incubator or via an oxygen mask.

Nasal cannula

This device is also used to deliver supplemental oxygen to preemie babies. It is a plastic tube which fits behind the ears, and there are two prongs which are placed in the nostrils. The nasal cannula is connected to an oxygen tank, a portable oxygen generator, or a wall connection in a hospital via a flow metre, oxygen flows into the 2 prongs.

Humidifier

When preemie babies need long-term oxygen therapy the air and oxygen mixture is often passed through a humidifier first. The humidifier moistens and warms the gases.

Continuous positive airway pressure (CPAP)

Is a treatment that delivers slightly pressurised air during the breathing cycle through a specially designed nasal mask or pillows. This keeps the windpipe open during sleep and prevents the episodes of blocked breathing in babies with apnoea and other respiratory problems. The mask does not breathe for your baby; the flow of air creates enough pressure when he/she inhales to keep his/her airway open.

Ventilator

A ventilator can help your baby breathe, or can breathe for them, if necessary. If a ventilator is needed your baby will be connected to the ventilator via an endotracheal tube, which is a plastic tube placed into the windpipe through the mouth or nose. A mixture of air and oxygen is blown down the endotracheal tube. There are a number of different types of ventilators, if your baby needs a specific ventilator that is not available at your hospital, he/she may be transferred to a hospital that does. There are 2 main types of ventilator, which are positive pressure ventilator and oscillatory ventilator or high-frequency ventilator.

Feeding tubes Nasogastric or Orogastric tubes Nutrition

The gastrointestinal system is immature in preterm infants, which means that these babies often have difficulty digesting food. It is important that preterm infants are provided with good sources of nutrition to help them develop and grow. Each preemie baby has unique nutrient needs which will be determined by a care provider. When a preterm infant is first born they may not be fed by mouth and so receive important nutrients through an IV line. Initially, premature infants often receive all of their nutrition through the IV, which means the nutrients enter the body through a blood vessel.

 

Once the baby has stabilised, he/she may start receiving nutrition from breast milk or formula. This time frame can vary depending on how unwell the baby is. Because premature babies are unable to feed directly from the breast or bottle until 32 to 34 weeks gestational age they may be fed by a thin, flexible tube. Feeding by a tube can be through the nose or mouth directly into the stomach, called nasogastric or orogastric tubes. A nasogastric tube is inserted through your baby’s nose, an orogastric tube through his/her mouth, down his/her throat and into the stomach. Feeds may start off quite small so as to prepare the babies immature system for digesting. Mother’s of preemies can pump their breast milk so that it can be fed to the baby through these tubes.

 

Although there are specially developed formulas, breast milk is the ideal source of nutrition for both preterm and full term babies. The reported benefits of human breast milk include a lower risk of;

• hospital-acquired infection
• Necrotizing Enterocolitis (NEC)
• Chronic lung disease

Incubator (Isolettes)

Preterm babies are usually cared for in an incubator where their temperature can be regulated and intravenous fluids can be administered safely in a stable environment. There are small holes on the side which allows nurses and doctors to examine and treat and you can touch your baby. The incubator keeps your baby warm with moistened air, which is important for preemies, as dry and hot air can dry out a preemies already vulnerable and fragile skin. Preemies have difficulty controlling their own body temperature and can lose a lot of water through their skin, these incubators help prevent that from happening. They can also help protect your baby from the noises in the NICU, infections, and excess handling.

Ambient oxygen analyser

Is a device inside the incubator that monitors the amount of oxygen in the surrounding air.

Phototherapy

Phototherapy is used to treat neonatal jaundice. Neonatal jaundice is caused by an excess of Bilirubin in the blood, which causes the skin and whites of the eyes to turn yellow. Phototherapy works by breaking down its concentration. Therapy may be given in the form of a phototherapy unit and/or a biliblanket.

Phototherapy unit

Is a lamp unit that shines blue light, not ultraviolet light, onto your baby’s bare skin.

Biliblanket

The biliblanket is a form of phototherapy that uses fibreoptic tubes that emit bright light to treat jaundiced babies. The blanket is placed directly against your baby’s skin and the fibres are used to transport a light source to your baby, absorption of the light leads to elimination of bilirubin.

IV line (Intravenous line)

An IV is a thin, flexible tube inserted into one of your baby’s main veins, it may be his/her arm, leg, scalp, or umbilical cord. Most babies in the NICU will have an IV line for fluids, nutrients, and medications. Rather than giving your baby injections through their fragile skin, every few hours, IVs allow certain medications to be given continuously. Doctors may use these medications to help with heart function, blood pressure, or pain relief.

 

Sometimes an IV line is required for a long time and/or to deliver larger volumes of fluids and medications, so a central catheter is used instead. They are inserted into the larger, more central veins of the chest, neck, or groin. This type of line lasts much longer than an IV line, so less changes are required, meaning less discomfort for your baby.

 

Vital signs monitor

The monitor leads are attached to sensor pads on your baby; it provides important information about how your baby’s major body systems are working. The information from several different types of monitors is often combined into one machine, which is displayed on a TV-style screen.

Cardiorespiratory monitor

Measures the heart and breathing rate of your baby. An alarm will sound if either gets too high, or too low relative to the normal level.

Pulse oximeter

Monitors the amount of oxygen in the baby’s blood by using an infrared light sensor. It is usually attached to your baby’s foot or hand. This is very important because too much or too little oxygen can cause long-term health problems.

Blood pressure monitor (Dinamap)

Will take your baby’s blood pressure at programmed intervals. It inflates a cuff that is wrapped around your baby’s arm and the results are fed into a machine that then displays the blood pressure reading.

Apnoea alarm

This device monitors breathing and sounds an alarm if your baby stops breathing for more than a preset time limit (e.g. 10- 20 s). The two main applications for these devices are to monitor the breathing of preterm babies and monitor the correct action of ventilators in the operating theatre and intensive care unit. Only occasionally, does a preemie baby have to go home with one of these alarms.

Scales

The scale may not be the most technologically advanced piece of equipment in the NICU but it is one of the most important. Every feeding, IV solution, and medication is calculated and based on your baby's weight, so it is critically important that the weight be accurate, up-to-date, and readily available at all times. Taking your baby’s weight is often part of the morning routine in the NICU, so it is taken at the same time and in the same way each day, which is then recorded on your baby’s weight chart. The weight is carefully corrected for the weight of the diaper and any equipment that is attached to the baby. It is usually recorded in grams and is accurate to within 5 grams (one pound = 454 grams).

 

 

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