Neonatal Intensive Care

What is Neonatal Intensive Care Unit?

A neonatal intensive care unit is a well-equipped unit used for correct and rapid intervention to probable problems in newborn babies, increasing the chances of survival and increasing the success rate during treatment. Neonatal intensive care units have all the technological equipment necessary for the treatment and care of the baby. The newborn baby is under constant surveillance by health professionals who are experts in their field.

Neonatal intensive care units always work together with Pediatric Surgery, Pediatric Cardiology, Pediatric Neurology, Pediatric Gastroenterology, Pediatric Metabolism and Endocrinology. The care/treatment services applied with the technological facilities in the neonatal intensive care unit are are as follows:

Respiratory Support (Ventilator): Respiratory failure can be seen in babies whose lungs are not developed properly during preterm birth. On the other hand, infections that may occur during or after childbirth can also cause respiratory distress. For such cases, respiratory support (ventilator) therapy has an important place. When necessary, the development of the lung is provided by the surfactant substance given to the newborn through the respiratory tract. The most important criterion in respiratory support is to ensure that the situations that develop with the least contact are observed at the highest level.

Total Parenteral Nutrition Support: In neonatal, intravenous feeding is used for oral feeding problems. Treatment should be started as soon as a malnutrition is detected. Delaying nutrition, which is extremely important for the growth and development of the newborn, can cause growth retardation and other permanent diseases. Parenteral nutritional support is considered as complementary therapies and long-term administration is not recommended. For this reason, the problem that causes malnutrition should be detected and treated quickly, and oral (enteral) nutrition should be continued when the digestive system can function properly.

Exchange Transfusion: Jaundice, which occurs in two out of three babies, usually resolves spontaneously. However, although it is very rare, the problem of jaundice can cause serious diseases. Common conditions such as genetic factors, premature birth, infections, malnutrition or certain blood and liver diseases are among the causes of jaundice. The increased bilirubin in the blood of the newborn baby accumulates in the cheeks, whites of the eyes and throughout the skin, causing a yellow appearance. In some cases, blood incompatibility is also observed as the cause of jaundice. In such cases, exchange transfusion is required. With blood exchange, blood containing unwanted substances is removed from the body and replaced with healthy blood. Care is taken to ensure that the blood to be given is compatible with the baby's blood.

Light Therapy (Phototherapy): The purpose of the light therapy applied in case of jaundice in the newborn baby is to remove the bilirubin material accumulated in the skin. The special wavelength rays used for this are kept in the baby's body and the bilirubin is dissolved and excreted in the urine. In cases where light therapy is not sufficient, exchange transfusion is applied.

Percutaneous Catheter Applications: Percutaneous catheter application is the opening of a vascular access to the heart through the thin vessels in the arms and legs of the newborn baby. Thus, the desired drug to be delivered to the bloodstream can be easily transferred. Percutaneous catheter application is performed by specialist doctors in neonatal intensive care units.

Thorax Tube: Thoracic tube insertion is applied in the treatment of lung collapse due to air leakage in the lung. Lung collapse in newborn infants can occur early after birth. For this problem, which manifests itself with difficulty in breathing, oxygen therapy is applied first. If there is no improvement, a thoracic tube is required. When improvement is seen, the thoracic tube is removed.

Bedside Ultrasonography (USG): Ultrasonography, which is a medical imaging examination, is performed with the help of ultrasonic sound waves to examine the internal organs and brain structure of the newborn baby in detail. USG is performed by specialist radiologists in neonatal intensive care units while the baby is in the incubator. Thanks to this method, organs such as liver, spleen, kidney and gall bladder can be examined. In addition, transfontanel cranial ultrasound is also applied to monitor brain development. The purpose of all these examinations is to examine whether there is an abnormal condition in the newborn.

Bedside Brain Electros (EEG): Electroencephalography (EEG) is the electrical examination of brain activity and its printing on paper. It is important in terms of examining the brain activities of the newborn baby and monitoring whether there is an abnormal condition. If there is any abnormality, it can be treated with early diagnosis. Otherwise, if treatments for brain anomalies are delayed, permanent damage may occur.

Bedside Heart Ultrasound (ECO): Some heart diseases can be seen in newborn babies due to congenital or preterm birth. Heart diseases can be diagnosed with regular check-ups by the doctor for one year from birth. Symptoms such as respiratory irregularities, high blood pressure or bruising immediately after birth may be signs of heart disease. In such cases, the heart can be visualized by the echocardiography (ECHO) method, which uses sound waves. Since no radiation is emitted, there is no harm to the baby.

Retinopathy Examination: Retinopathy is one of the most important eye diseases seen in newborn babies. Although the developmental stage of the eye in humans continues until the primary school years, the most basic development covers the birth and the close period (48-52 weeks from the last menstrual period). From this point of view, eye development continues after birth, especially in premature babies, since the vessels of the eye cannot complete their development fully. However, due to the delivery of oxygen to premature babies in the intensive care unit, the eye vessels may develop abnormally. In this case, retinopathy can cause discomfort. Since early diagnosis is very important for the treatment to be effective, examination and follow-up are absolutely necessary. In an abnormal situation, drug injections or laser applications are used in the treatment of retinopathy.

Which Diseases Does Neonatal Intensive Care Treat?

It is a unit that provides advanced medical and surgical services, in the neonatal intensive care unit, in common conditions such as premature birth, multiple pregnancy, congenital anomalies, babies who swallowed meconium before birth, babies at risk of brain and other organ damage due to difficult delivery, babies of diabetic mothers, jaundice, infection, etc.

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