Neonatal Intensive Care Unit (NICU)

What is a Neonatal Intensive Care Unit?

A Neonatal Intensive Care Unit (NICU) is a highly specialized facility designed to provide immediate and advanced medical intervention for newborns who require intensive monitoring and treatment. These units are equipped with state-of-the-art technology to manage conditions that threaten the survival and development of newborns. Each infant is continuously monitored by a team of specialized physicians, nurses, and neonatal healthcare professionals.

NICUs operate in close collaboration with multiple pediatric specialties, including Pediatric Surgery, Pediatric Cardiology, Pediatric Neurology, Pediatric Gastroenterology, Pediatric Metabolism, and Endocrinology. The goal is to ensure that newborns receive comprehensive, multidisciplinary care through advanced diagnostic and therapeutic methods.

Advanced Care and Treatments Provided in the NICU

Respiratory Support (Ventilator)

Premature infants often experience respiratory distress due to underdeveloped lungs. Additionally, infections during or after birth can impair breathing. In such cases, mechanical ventilation plays a vital role in sustaining oxygen exchange. When necessary, a surfactant—a substance that helps the lungs expand—is administered through the airways. The primary goal of respiratory support is to minimize handling while ensuring optimal monitoring and stabilization of the newborn’s breathing.

Total Parenteral Nutrition (TPN)

When oral feeding is not possible, intravenous nutrition (TPN) is provided to meet the baby’s metabolic needs. Early initiation of nutritional support is crucial to prevent growth retardation and long-term complications. Although parenteral nutrition is an essential supportive treatment, it is recommended only for short-term use. Once the gastrointestinal system becomes functional, enteral (oral) feeding should be resumed as soon as possible.

Exchange Transfusion

Jaundice is common among newborns and usually resolves spontaneously. However, in rare cases, it may indicate serious underlying conditions such as genetic disorders, prematurity, infections, or liver dysfunction. Elevated bilirubin levels can cause yellow discoloration of the skin and eyes. In cases of blood incompatibility or severe jaundice, exchange transfusion is performed to replace the infant’s blood with compatible donor blood, effectively reducing bilirubin levels and preventing complications.

Phototherapy (Light Therapy)

Phototherapy is a standard treatment for neonatal jaundice. It uses specific wavelengths of light to break down bilirubin accumulated in the skin, allowing it to be excreted through urine. When phototherapy alone is insufficient, exchange transfusion may be required. The procedure is non-invasive and highly effective when applied under medical supervision.

Percutaneous Catheterization

Percutaneous catheter placement involves inserting a fine catheter through a peripheral vein in the newborn’s arm or leg, extending toward the heart. This allows for the safe administration of intravenous medications and nutrition. The procedure is performed exclusively by neonatal specialists in the NICU under sterile conditions.

Chest Tube (Thoracostomy)

In cases of pneumothorax (collapsed lung) caused by air leakage in the lungs, a chest tube is inserted to re-expand the lung and restore normal breathing. Pneumothorax may occur shortly after birth and manifests with respiratory distress. If oxygen therapy fails to resolve the condition, thoracic drainage becomes necessary. Once improvement is achieved, the chest tube is removed.

Bedside Ultrasonography (USG)

Ultrasound imaging is performed directly at the incubator to evaluate the structure and function of internal organs such as the liver, spleen, kidneys, and gallbladder. Cranial ultrasound (transfontanelle sonography) is also performed to monitor brain development. Conducted by radiology specialists, these non-invasive examinations provide critical insights into the newborn’s organ and brain health.

Bedside Electroencephalography (EEG)

EEG is used to record and analyze the brain’s electrical activity. In newborns, this test is crucial for detecting potential abnormalities in brain function. Early identification of irregularities allows for timely medical intervention, preventing long-term neurological damage or developmental impairment.

Bedside Echocardiography (Echocardiogram)

Some newborns, especially those born prematurely or with congenital anomalies, may have heart conditions detectable soon after birth. Symptoms such as respiratory distress, hypertension, or cyanosis may indicate cardiac issues. Echocardiography uses ultrasound waves to visualize the heart’s structure and function. Since it does not involve radiation, it is entirely safe for newborns and essential for diagnosing congenital heart diseases.

Retinopathy Screening

Retinopathy of prematurity (ROP) is one of the most common eye disorders seen in premature infants. The development of retinal blood vessels continues after birth, particularly in babies born before 32 weeks of gestation. Oxygen therapy in the NICU can sometimes cause abnormal vascular growth in the retina, leading to ROP. Early diagnosis and regular screening are vital for preventing vision loss. When necessary, treatment may include laser therapy or intravitreal medication to stabilize retinal development.

Conditions Treated in the Neonatal Intensive Care Unit

The NICU provides advanced medical and surgical care for a wide range of conditions, including:

• Premature birth

• Multiple pregnancies

• Congenital anomalies

• Meconium aspiration syndrome

• Birth-related brain or organ injuries

• Infants of diabetic mothers

• Neonatal jaundice

• Severe infections and sepsis

• Metabolic and respiratory disorders

With its expert neonatal care team and advanced medical infrastructure, the NICU plays a crucial role in improving survival rates, supporting healthy development, and providing the best possible start in life for newborns requiring intensive care.