Preemie Terms Its confusing to keep up with all the medical terms for tests, conditions, and progress for me. Here's a list of common ones for you to make it easier. Adjusted Age Also known as “corrected age.” This is your child’s chronological age minus the number of weeks he or she was born early. For example, if your 9-month-old was born 2 months early, you can expect him or her to look and act like a 7-month old. Usually you can stop age-adjusting by the age of 2 or 3. Anemia A condition in which the hemoglobin or hematocrit levels in the blood are lower than normal. Apgar Score A numerical summary of a newborn’s condition at birth based on five different scores, measured at 1 minute and 5 minutes. (Additional measurements are made every five minutes thereafter if the score is less than 7 at five minutes, until the score reaches 7 or greater.) The acronym for Apgar is: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. These are what is assessed to get a score. Premature infants generally have lower scores than full-term infants, but the Apgar score does not accurately predict future development. Apnea Cessation of breathing lasting 20 seconds or longer. Also known as an apneic episodes or apneic spells. It is common for premature infants to stop breathing for a few seconds. They almost always restart on their own, but occasionally they need stimulation or drug therapy to maintain regular breathing. The heart rate often slows with apnea; this is called bradycardia. The combination of apnea and bradycardia is often called an A&B spell. Apnea gradually becomes less frequent as premature infants mature and grow. There is no relationship between apnea and sudden infant death syndrome (SIDS). Bethamethasone A steroid medication given to the mother before birth to help the baby’s lungs mature more quickly. It is most effective if it is given more than 24 hours before delivery. Betamethasone also helps intestines, kidneys and other systems to mature. Bilirubin Yellow chemical that is a normal waste product from the breakdown of hemoglobin and other similar body components. The placenta clears bilirubin from the fetus’s blood, but after delivery this task belongs to the infant. It usually takes a week or more for the newborn’s liver to adjust to its new workload. When bilirubin accumulates, it makes the skin and eyes look yellow, a condition called jaundice. Blood Gas A blood test used to evaluate an infant’s level of oxygen, carbon dioxide and acid. This test is significant because it helps to evaluate an infant’s respiratory status. Bradycardia An abnormally low heart rate. Bradys are usually associated with apnea in premature infants. During these spells the infant will stop breathing for at least 15 seconds and the heart rate will start to slow, also referred to as an “A&B spell.” Gentle touching or other stimulation almost always restarts the breathing and increases the heart rate. Medications (theophylline or caffeine) are often used to treat these spells in newborn babies. Central Venous Line The central venous line (CVL), also called the central venous catheter (CVD), is a type of intravenous tube used to give fluids and medications. The catheter is placed in a major vein of the body during surgery or by insertion through a vein in the arm, leg or head. Continuous Positive Airway Pressure (CPAP) Supplemental oxygen or room air delivered under pressure though either an endotracheal tube (tube that goes directly into the infant’s lungs) or small tubes or prongs that sit in the nostrils. Delivering oxygen under pressure helps keep air sacs in the lungs open and also helps maintain a clear airway to the lungs. Nasal CPAP (NCPAP) is commonly used immediately after removing the endotracheal tube to treat apnea and/or prevent the need for an endotracheal tube and ventilator. Crit Slang for hematocrit, this is a test used to determine the percentage of red blood cells compared to total blood volume. It is commonly used to test for anemia. It is significant in that is helps show a baby’s ability to supply oxygen to his or her organs and tissues. Echocardiogram (”Echo”) Ultrasound picture of the heart. This is a painless, non-invasive procedure that takes accurate pictures of almost all parts of the heart. Many preemies have a cardiac ultrasound if the doctor is looking for evidence of a patent ductus arteriosus. Endotracheal Tube (ETT or ET Tube) Tube placed through the mouth or nose into the throat and the child’s trachea (windpipe). This tube provides a secure pathway through which air can be circulated to the lungs. Gavage Feeding Feeding a baby through a nasogastric (NG) tube. Also called tube feeding. Hyperbilirubinemia Another name for jaundice. Incubator Another name for an isolette. Intracranial Hemorrhage Bleeding within the skull. Bleeding most often occurs within the ventricles of premature infants, but it can occur anywhere within or on the outside of the brain. Intraventricular Hemorrhage (IVH) Bleeding into the ventricles (fluid-filled spaces) within the brain. All of us have two small, fluid filled ventricles in the center of our brains. These ventricles manufacture cerebrospinal fluid. The fluid-filled space within those ventricles are called the intraventricular space. The areas just outside of those ventricles are the periventricular areas. Adjacent to the outer wall of the ventricle is the germinal matrix, an area of immature nerve cells and tender blood vessels. As the preterm baby matures, the germinal matrix tissues migrate out into the substance of the brain, and the germinal matrix gradually disappears. The tender blood vessels within the germinal matrix can rupture and bleed; this is called a germinal matrix hemorrhage or grade I intraventricular hemorrhage (IVH). The bleeding, if severe, can lead to bleeding within the ventricle itself, a grade II IVH. If there is a lot of bleeding, the ventricles can become enlarged and swollen by the blood, which is a grade III IVH. If the bleeding either involves or secondarily injures the periventricular brain tissue, it is a grade IV IVH or IVH with extension of the hemorrhage outside of the ventricular system into the brain substance. Isolette Also known as an incubator, an isolette is a clear plastic, enclosed bassinet used to keep prematurely born infants warm. Preemies often loose heat very quickly unless they are put in a protected thermal environment. The temperature of the isolette can be adjusted to keep the infant warm regardless of the infant’s size or room temperature. Jaundice Also known as Hyperbilirubinemia. Jaundice comes from the accumulation of a natural waste product, bilirubin. As red blood cells and other tissues are replaced in the body, the waste products of their breakdown are normally eliminated by the liver. Bilirubin has a yellow color, and when the levels are high it stains the skin and other tissues. A little jaundice can be expected in all newborns. If the jaundice is higher than usual, it can usually be treated with phototherapy (special lights). Phototherapy is so effective in helping the liver excrete bilirubin that elevated levels are rarely a problem. Prematurely born infants may have elevated bilirubin levels for several weeks. Kangaroo Care Skin-to-skin contact between parent and baby. During kangaroo care, the baby is placed on the parent’s chest, dressed only in a diaper and sometimes a hat. The baby’s head is turned to the side so the baby can hear the parent’s heartbeat and feel the parent’s warmth. Kangaroo care is effective, but it’s limited to babies whose condition is not critical. Low Birth Weight Any baby with a birth weight under 2,500 grams (about 5? pounds) is a low birth weight baby (LBW). Meconium A dark green, sticky mucus, a mixture of amniotic fluid and secretions from the intestinal glands, normally found in infants’ intestines. It is the first stool passed by the newborn. Passage of meconium within the uterus before birth can be a sign of fetal distress. The meconium is very irritating to the lungs. Nasal Cannula Light, flexible tube used to give supplemental oxygen to a child. Oxygen flows through two prongs extending into the nostrils. Nasogastric Tube (NG Tube) Narrow, flexible tube inserted through the nostril, down the esophagus, and into the stomach. It is used to give food or to remove air or fluid from the stomach. Necrotizing Enterocolitis (NEC) Swelling, tenderness and redness of the intestine caused by an infection or decreased blood supply to the intestine. The seriousness of NEC varies: it may injure or destroy parts of the bowel, or it may affect only the innermost lining or the entire thickness of the bowel. Neonatologist A pediatrician who has received 4-6 years of training after medical school in preparation for treating premature or sick newborns. This is the person who usually directs your baby’s care if hospitalization in an NICU is required. Oximeter Machine monitoring the amount of oxygen in the blood. A tape-like cuff is wrapped around the baby’s toe, foot, hand or finger. This machine allows the NICU staff to monitor the amount of oxygen in the baby’s blood without having to obtain blood for laboratory testing. 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. Phototherapy Light therapy to treat jaundice. Peripherally Inserted Central Catheter (PICC) A form of intravenous access that can be used for a prolonged period of time. A PICC is inserted in a peripheral vein, such as the cephalic vein, basilic vein, or brachial vein and then advanced through increasingly larger veins, toward the heart until the tip rests in the distal superior vena cava or cavo-atrial junction. Sats Term for blood oxygen saturation. Tachycardia A faster than normal heart rate. Tachypnea A faster than normal respiratory rate. Ventilator (”Vent”) A machine that assists adults or children to breathe. Lung immaturity in prematurely born infants is the most common reason for a newborn to require a ventilator. Very Low Birth Weight (VLBW) A birth weight of less than 1,500 grams (about 3.3 pounds). About 1.3% of all births result in babies with a very low birth weight.