NICU Tests and Procedures

Your baby will have a number of different tests and procedures while in the NICU.

Your baby's care team will tell you what tests and procedures are recommended and inform you of the results. These are some of the more common tests, treatments or procedures done in the NICU. Your baby may need additional specialized tests or treatments, depending on his/her medical condition.

Antibiotic Treatment

Newborn infants may be treated with antibiotics (drugs that fight infection) when we think that a serious infection may be the reason why they are sick, either at the time they are admitted to the NICU, or later during their time in the newborn ICU.

Arterial Line

Small line placed into an artery (at the wrist or ankle) that allows continuous monitoring of blood pressure and drawing blood for lab tests.

Blood Transfusion

Infants in the NICU sometimes need blood transfusions to correct anemia (too few red blood cells in the circulation) or low blood pressure that results from blood loss. This is done when the physicians think that the baby’s health or survival is in danger. Sometimes babies need transfusion of other blood products, called “platelets” or “plasma” to correct potentially dangerous bleeding problems. 

CPAP (Continuous Positive Airway Pressure)

A device that provides extra pressure to the breathing passages via a rubbery mask or prong set on the nose. The baby is breathing on their own but this machine gives some extra pressure even as the baby exhales, to help keep the lungs from collapsing.

ECMO

The University of Michigan provides extracorporeal life support for newborns who are experiencing life threatening heart or lung illness. ECMO, which stands for Extracorporeal Membrane Oxygenation, is basically heart/lung bypass performed outside of the operating room. U- M’s ECMO Program is the oldest and one of the largest ECMO programs in the nation. Our ECMO team cares for newborns in the NICU along with the neonatal nurses and physicians. Each patient on ECMO is cared for both by an ECMO specialist as well as a NICU nurse. The ECMO specialists are highly skilled nurses and respiratory therapists who are trained in operation of the ECMO circuit and provide complete, patient centered care during a critical time in their hospital stay. Please visit our ECMO page for more information about this procedure.

Endotracheal tube (ETT)

A breathing tube is passed through the mouth or nose, into the trachea (windpipe) and connected to the ventilator. It is taped in place to the upper lip and cheeks.

Extubate

A procedure to remove the breathing tube from the trachea when ventilator support is no longer needed.

Eye Examination

Many babies born prematurely will have one or more examinations of the retina, which is the back of the eye, by an eye doctor (Ophthalmologist) after they have been in the NICU for a while. Babies who have this eye examination are being checked for evidence of a common complication of prematurity called “Retinopathy of Prematurity” (ROP), which may cause visual impairment or even blindness. Early detection through these eye examinations and treatment (if necessary) is very important. 

Heel Stick

Use of fatty part of the heel to draw small amounts of blood for tests. (Larger amounts are drawn from indwelling IV lines or from a larger vein in the arm.)

High Frequency Oscillator Treatment (HFO)

This is another type of breathing machine that delivers very small breaths at a very high rate. The Oscillator is used for babies who are either not responding well to conventional ventilation or who have lung problems that respond better to this type of ventilator.

Intravenous Line (IV)/Peripheral Intravenous Line

Small line placed into the vein, on the hand, foot, forearm or lower leg for delivery of fluid, usually sugar water, medications, and sometimes IV nutrition.

Intubate

A procedure used to put a tube through the baby's mouth or nose into the windpipe. This tube is then attached to the equipment that assists breathing (the ventilator).

Nasal Cannula

Small plastic prongs are placed in the nostrils to provide small amounts of oxygen.

Nasogastric Tube (NG)

A flexible tube that goes through baby's nose into the stomach. Used to keep the stomach empty at first and can also be used to feed baby when appropriate. It is taped in place on the cheek.  Sometimes it is placed through the mouth instead of the nose.

Oxygen Saturation

A small sticky probe placed on the baby's hand or foot that allows the oxygen level to be viewed on the bedside monitor.

Phototherapy (“Bili Light”)

Treatment with special blue-tinted lights to help break down bilirubin, the yellow pigment that causes newborn jaundice, so it can leave the body in the stool or urine. Babies wear protective eye patches while they are receiving phototherapy.

PICC Line (Percutaneous Intravenous Central Catheter)

A long thin line inserted through the baby's skin, usually into a vein in an arm or leg. It is passed through a blood vessel that goes deep into the baby's body. They are used to give IV fluids, IV nutrition and medications. They usually last longer than a regular peripheral IV.

Therapeutic Hypothermia

Therapeutic hypothermia, or “cooling”, is a treatment for babies who are born at or near their due date that we think might have had a brain injury caused by interruption of blood flow or oxygen delivery. Many people have heard of icing a joint that is hurt. Even though the brain is more complicated than a joint, cooling can still help reduce the effects of brain injury in some babies. The baby is placed on a mattress with circulating water inside it, for 72 hours. The water is cool to begin with, and then the machine pumping the water automatically adjusts the water temperature to keep the baby's body temperature slightly cool, between 33° and 34° C (91.4° - 93.2° F). Cooling the entire body is the most commonly used way to ensure that the brain is cooled into a therapeutic temperature range. Our NICU participated in one of the pioneering clinical trials that showed “cooling” helped babies with brain injury.

Ultrasound

Your baby may have ultrasound pictures of the head, heart or belly, or other locations. The machines used are like those used to look at a baby inside the womb. Common reasons to do an ultrasound in a baby in the NICU include checking for problems in the brain, heart, or urinary system, and checking the position of lines or tubes.

Ventilator Treatment

Treatment using a breathing machine. The most common type of ventilator is called a conventional ventilator. (In the Brandon NICU, the AVEA is the brand of conventional ventilator that is used.) A conventional ventilator provides positive pressure breaths through a breathing tube at a rate similar to what the baby would breathe on their own. The volume of air delivered is approximately the amount that the baby would breathe on their own, but sometimes extra pressure is needed to deliver each breath when the baby has lung problems, for example from prematurity or an infection. The ventilator not only provides positive pressure breaths but it may also provide additional oxygen. The ventilator is continuously adjusted to give babies the additional support that is needed. Respiratory Therapists are the members of our team that adjust and maintain the ventilators.

X-ray

Your baby may have X-ray pictures of the chest or the abdomen (belly), or other locations. Common reasons to take an X-ray in the NICU include checking for correct position of lines or tubes that we place, determining the cause of a lung, heart or intestinal problem, or detecting a suspected complication.