Here are some of the more commonly performed tests and procedures administered to premature and seriously ill newborns in the Neonatal Intensive Care Unit (NICU) at Paoli Hospital.
Arterial Blood Gas (ABG)
ABG measures the blood's oxygen and carbon dioxide levels, as well as the acidity (pH) of the blood in the baby’s lungs. These measurements guide the neonatologist in decisions about oxygen therapy and ventilator care. Special monitors may be used to help eliminate frequent blood drawing:
The transcutaneous monitor involves a heated electrode that increases the blood circulation to the area where skin assessments of oxygen and carbon dioxide levels are made and recorded on the monitor.
The pulse oximeter measures the amount of oxygen in the blood indirectly with a special light sensor applied to the hand or foot.
Complete Blood Count (CBC)
CBC measures the types and numbers of cells in the blood. This test may show signs of infection or anemia requiring intravenous (IV) replacement of such blood products as red blood cells and platelets.
This test measures essential minerals in the baby’s blood. Electrolytes play a vital role in body chemistry and may be adjusted in an IV solution according to the test findings.
A Note About Blood Tests: When considering the number of tests needed in treating a baby, one might be concerned about the amount of blood drawn. Be assured that, with modern diagnostic equipment, only minute amounts are required, and the nursing staff is skilled in taking specimens from the infant’s heel, where the blood supply is particularly rich.
If a neurological problem is suspected, an electroencephalogram (EEG) may be performed. Small disc electrodes are attached to the baby’s scalp with water and soluble adhesive paste to transmit and record the electrical activity of the brain. A related study, the auditory brain stem response test (ABR), is useful in screening high-risk babies for hearing problems.
Radiology and Nuclear Medicine Diagnostics
The hospital's radiology and nuclear medicine teams perform highly sophisticated diagnostic procedures for the NICU on a 24-hour basis. Chest X-rays and ultrasound scans of the brain or kidneys are done using portable bedside equipment. Echocardiograms create an image of the heart’s structures and functions, again at crib-side.
The imaging techniques in nuclear medicine involve the injected use of minuscule amounts of radioactive compounds that allow the physician to see and record conditions in specific parts of the body. The radiopharmaceuticals used are short-lived in strength, quickly eliminated from the body and, therefore, not harmful to the baby.
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