What is a NICU? Neonatal Intensive Care Unit

Specialized Care for Premature Newborns

Nurse tending to newborn in incubator
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NICU is an acronym that stands for Neonatal Intensive Care Unit. The NICU is the department of the hospital which cares for prematurely born babies (neonates) who are not fully developed, and therefore are unable to survive on their own without the assistance of monitoring equipment, incubators, and breathing apparatus. Babies may also be admitted to the NICU if they had problems during delivery or developed a problem soon after birth (before going home) that requires the specialized care available in the unit.

You will usually hear the name shortened  and pronounced "NICK-yoo" as opposed to spelling out the letters or saying the full name of the department.

Careers and Staff of the NICU

Careers that are largely involved with caring for patients in the NICU are doctors such as neonatologists, pediatricians, and OB/GYNs, as well as a variety of nurses who specialize in neonatal care, including neonatal nurse practitioners and registered nurses, and technicians who help operate and maintain the equipment in the NICU.

A variety of specialists treat conditions often seen in the NICU, including neurologists, cardiologists, and surgeons. Other therapists and professionals will provide care in NICU along with their duties other areas of the hospital, including respiratory therapists, speech-language pathologists, registered dietitians, physical therapists, pharmacists, lab technicians, social workers, and chaplains.

Levels of Care in NICU

The American Academy of Pediatrics categorizes hospital nurseries based on the level of neonatal care they provide. These were updated in 2012. NICUs are categorized by levels based on the ages of babies they are able to support. Level I facilities are well newborn nurseries. Level II is a specialty-level facility for stable or moderately ill newborn infants who are born at 32 weeks of gestation or more and who weigh at least 1500 grams at birth.

NICU levels of care are Level III and Level IV.

Level III NICU: For newborns born at fewer than 32 weeks of gestation, weigh under 1500 grams, or have medical or surgical conditions. These facilities have continuously available neonatologists, neonatal nurses, respiratory therapists, and equipment that can provide ongoing life support.

Level IV NICU: In addition to the capabilities of care of a Level III NICU, the Level IV NICU has pediatric medical and pediatric surgical specialty consultants available continuously. They are able to act on complex conditions and surgical repairs. Often a Level IV NICU is a regional facility serving a larger area, with newborns requiring care transported to the facility.

Conditions Treated in the NICU

The March of Dimes lists these common conditions of premature and sick newborns that are treated in the NICU:

  • Anemia due to loss of blood or inadequate iron storage.
  • Breathing problems due to lung development, birth defects, or infections, which may require a ventilator or oxygen.
  • Heart defects including slow heart rate and abnormalities of the structure of the heart and vessels, 
  • Feeding problems requiring intravenous feeding or a feeding tube.

Sources

Levels of neonatal care. PEDIATRICS. 2012;130(3):587–597. doi:10.1542/peds.2012-1999.

Common conditions treated in the NICU. http://www.marchofdimes.org/complications/common-conditions-treated-in-the-nicu.aspx#.

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