Advanced Neonatal Nurse Practitioner

Appropriate for Gestational Age.  When birth weight is plotted on a weight chart for the babies gestational age, it falls between the 10^th and 90^th centile.

Large for Gestational Age.  When birth weight is plotted on a weight chart for the baby’s gestational age, it is above the 90^th centile.

Intrauterine Growth Restriction.  Foetal weight falls below the 10^th centile and is due to physiological and pathological events which result in a reduction in foetal growth.

Low Birth Weight < 2.5 kg

Very Low Birth Weight <1.5 kg

Extremely Low Birth Weight <1kg

Mother is transferred pregnant to a centre that can provide a higher level of neonatal care

Newborn infant is transferred to a centre that can provide a higher level of care (could be medical, surgical or cardiac)

Respiratory Distress Syndrome.  A condition seen predominately in premature babies due to the lack of surfactant.

Intraventricular Haemorrhage.  A bleed, seen in preterm baby’s brain, which commences in the germinal matrix and can result in bleeding into the lateral ventricles.

 Patent Ductus Arteriosus.  A condition where oxygenated blood shunts left to right from the aorta to the pulmonary trunk.

Ventricular Septal Defect.  A defect between the right and left ventricle of the heart.

Atrial Septal Defect.  A defect between the right and left atrium of the heart.

Necrotising Enterocolitis.  Inflammation of the bowel.

Disseminated Intravascular Coagulation.  Widespread activation of coagulation of the blood, resulting in consumption of coagulation factors and platelets, Fibrin deposition and secondary fibrinolysis.  DIC is always secondary to other diseases.

Transient Tachypnoea of the Newborn.  A respiratory condition that presents from birth when the baby fails to absorb/clear lung fluid.

Meconium Aspiration Syndrome.  A respiratory condition that results from the aspiration of meconium in-utero.  Inhaled meconium can lead to obstruction and collapse of alveoli or alveoli gas trapping in airways partially blocked.

Chronic Lung Disease.  Chronic pulmonary disease that develops in the neonatal period, especially in premature infants who as a result of oxygen, barotrauma, respiratory infections, etc. sustain lung injury.  Oxygen requirement in a premature infant at 36 weeks post conceptual age.

Persistent Pulmonary Hypertension of the Newborn.  In an infant with a normally structured heart, there is failure of the pulmonary vascular resistance to fall following delivery, which results in right to left shunting of blood through the ductus arteriosus and/or foramen ovale.

Cytomegalovirus

Congenital Heart Defect

Congenital Diaphragmatic Hernia

Pulmonary Interstitial Emphysema.  A type of respiratory air leak.  Air collects in the pulmonary interstitium.

Retinopathy of Prematurity.  A condition that stops the normal progression of newly forming retinal vessels in the underdeveloped eye of the preterm baby.

Periventricular Leukomalacia.  Necrosis of periventricular white matter as a result of ischaemia.

Fraction of Inspired Oxygen

Kilopascal

The measured force a gas exerts as it escapes from a liquid to a gaseous medium or from one compartment to another.  Can be measured in mmHg or KPa.  1 KPa =7.5 mmHg

Partial pressure of arterial oxygen.

Percentage of oxygen saturation of arterial blood.

Partial pressure of arterial carbon dioxide.

the measure of acidity or alkalinity.

The relative excess of bicarbonate ions or a measure of how well the ‘buffers’ in the blood are handling the normal acid metabolites other than CO₂ produced by the body.

pH is less than normal due to an increase in acid and/or decrease in base.

pH is greater than normal due to a decrease in acid and/or increase in base.

A condition in which the pH is below normal due to an elevated pCO₂

A condition in which the pH is above normal due to a decreased pCO₂

A condition in which the pH is below normal due to a deficiency in bicarbonate ions.

 A condition in which the pH is elevated due to an increase in bicarbonate ions.

Endotracheal Tube

Peak Inspiratory or Inflating Pressure

Positive End Expiratory Pressure

Expiratory Time

Inspiratory Time

Proportion of time spent in inspiration and expiration

Cycles or breaths per minute

Synchronised Intermittent Mandatory Ventilation.  A mode of trigger ventilation whereby the baby triggers a pre-set number of ventilator breaths.  Any additional breaths taken by the baby are not supported by the ventilator.

Synchronised Intermittent Positive/Pressure Ventilation/Patient Trigger Ventilation/Assist Control.  A mode of trigger ventilation whereby every breath the baby takes is supported by the ventilator

High Frequency Oscillation Ventilation.  A mode of ventilation where a constant mean pressure is provided throughout the respiratory cycle with an oscillating pressure imposed upon it and delivered at very high rates (10–15 hertz or 600–900 breaths per minute).

Continuous Mandatory Ventilation.  Ventilation breaths are delivered with inspiratory flow, rate, PIP, PEEP, Te and Ti set by the clinician.

Volume Targeted Ventilation.  A mode of ventilation which is intended to provide the infant with a consistent tidal volume.

Continuous Positive Airway Pressure

nasal Continuous Positive Airway Pressure

Bi-level nasal CPAP (Trade name)

Delivery of sighs above a baseline nCPAP pressure that may be timed at a rate specified by the clinician or triggered by the patient’s own inspiratory efforts.

Temperature is controlled by setting the air temperature to maintain the baby in a neutral thermal environment.

Umbilical Arterial Catheter

Umbilical Venous Catheter

Percutaneous Inserted Central Catheter line

(Na)  135–145 mmol/l

(K)  3.5–5.5 mmol/l

(Ca)  2.1–2.6 mmol/l

3.6–5.4 mmol/l

Bilirubin (SBR) (Total)  2–24 micromol/l

depends upon gestation and days old, 14–18g/dL

Packed Cell Volume.  At birth (mean), 40–60%

Neutral Thermal Environment.  The environmental temperature which allows the baby to use the least amount of oxygen to maintain a normal temperature.