The NICU Respiratory Therapy Core Team is a specialized group of therapists that work specifically in this area. These therapists are Neonatal Resuscitation Program (NRP) certified and S.T.A.B.L.E (Sugar, Temperature, Artificial breathing, Blood pressure, Lab work, Emotional support) Program Certified.
The NICU Respiratory Therapist are responsible for the following in the care of the neonate:
Mechanical Ventilator Management
Respiratory Therapy is responsible for all mechanical ventilator management. Infants in the NICU are ventilated using pressure-limited ventilation, high frequency oscillatory ventilation (HFOV), and nasal-pharyngeal CPAP (NPCPAP). The mode of ventilation used depends on the severity of the infant's respiratory status. Then ventilators are checked every two hours by the RT and the babies are monitored continuously by the RT staff and the NICU nursing staff.
Respiratory Therapy administers and monitors all oxygen therapy. The modes of oxygen administration used most often are oxyhoods and nasal cannulas. Oxygenation is monitored according to blood gases and oxygen saturation monitors.
The RT staff will draw, analyze, and report all blood gases. We also assists in drawing labs from indwelling catheters and/or puncture sites.
RT manages the hemodynamic monitoring which ensures proper reading of the blood pressure from the umbilical line.
Inhaled Nitric Oxide (iNO) Administration
Inhaled nitric oxide is indicated for neonates>34 weeks gestation with documented evidence of Persistent Pulmonary Hypertension of the Neonate (PPHN). RT administers iNO and remains at the neonates bedside until it is discontinued.
This "sleep test" uses six channels to monitor an infant's sleep pattern to check for reflux, periodic breathing, apnea, and heart rate abnormalities. The six channels include: ECG to monitor heart rate, a thermistor in the nares and above the lip to observe airflow from the nose and mouth, and actimeter in the hand to check for activity of the infant, pH probe inserted into the esophagus to measure the acidity of gastric contents which may indicate reflux, and an oxygen saturation monitor to watch for desaturation during sleep.
Home Cardio-Respiratory Monitors
If an infant goes home on a cardio-respiratory monitor (also known as an apnea monitor), the NICU Respiratory Therapist will set up and instruct parents on the AMI apnea monitor and help them feel comfortable in applying the monitor to their infant.