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Neonatal life support is a broad term that may refer to any medical techniques or gear needed to keep a newborn baby, or neonate, alive. Distressed babies are typically transferred to the Neonatal Intensive Care Unit (NICU) of the hospital and placed in an incubator to receive critical care. Neonatal life support can include close observation of the baby’s vital signs, temperature control, intravenous or tube-fed nutrition, neonatal resuscitation, and oxygenation.
A baby may be in distress and in need of neonatal life support for many reasons. The amniotic fluid may contain an early bowel movement of the baby, called meconium. The infant may be pre-term, or delivered before reaching full development, or the baby could have any number of other symptoms of fetal distress. All of these factors are taken into account by the doctors, nurses, and other medical experts so that they can prepare to give the proper neonatal care as quickly as possible.
Neonatal resuscitation is one of the most important and immediate concerns in neonatal life support. This is typically done by a doctor or nurse in the delivery room when the baby is in distress and stops breathing. The baby may begin to gasp, as the infant’s heart rate and blood pressure drops, and then stop breathing, or the baby may fail to breathe at all after delivery. In some cases, tapping the baby may stimulate breathing, especially in vigorous infants. For less healthy babies or those who don’t respond to stimulation, resuscitation must begin immediately.
The infant will be dried and placed in a warmer bed to prevent cold shock, positioned so that the airway is clear, and then given respiratory support, usually in the form of mask and bag ventilation. The bag inflates with a certain amount of oxygen, and then the bag is squeezed that the oxygen flows through the mask into the baby’s nose and mouth at the desired pressure. The circulation is then checked and if the heart rate falls below a certain point, the baby may be given chest compressions. The baby can be intubated, or have a breathing tube inserted into the body, if it doesn’t seem like the mask and bag system is working well enough. Sometimes the infant is also given a drug called epinephrine to speed up the heart rate.
Throughout neonatal resuscitation and any subsequent neonatal life support, close monitoring of circulation, respiration, and temperature is a priority. The heart rate is usually observed through the umbilical artery, as other blood vessels are less well formed, and an umbilical artery catheter (UAC) is used to measure blood pressure and take blood samples. Likewise, an umbilical vein catheter (UVC) uses the umbilical vein to infuse medicines and nutrition into the infant’s blood.
The newborn may also be hooked up to a continuous positive air pressure (CPAP) machine, which assists his or her breathing. Sophisticated incubators often play a large role in neonatal life support, equipped with monitors for heart rate, temperature, respiration, brain activity, and blood pressure. The incubator keeps the infant warm, protects the baby from germs, and maintains a high level of humidity to help balance fluids in the body.