Treatment in the NICUTTreatment in the NICUTreatment in the NICUEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANADrug treatment;Non-drug treatmentPrenatal Adult (19+)NA2009-10-31T04:00:00ZJonathan Hellmann, MBBCh, MHSc, FCP(SA), FRCPC12.000000000000043.0000000000000794.000000000000Flat ContentHealth A-Z<p>Read about the Neonatal Intensive Care Unit (NICU). The goal of the NICU is to allow a premature baby to grow as they would have in the womb.</p><p>There are many types and degrees of intervention that premature babies may go through. The more premature a baby is, the more likely they will require some form of intervention due to their condition.</p><h2>Key points</h2> <ul><li>There are risks and benefits to all treatments, however the probable benefits often outweigh the risks.</li> <li>Doctors will often know the correct form of treatment for a certain condition because of research, however there is always a degree of uncertainty.</li> <li>In some cases, treatment may not work, at which point parents and health-care providers must make a decision about next steps.</li></ul>
Traitement dans l’unité néonatale des soins intensifsTTraitement dans l’unité néonatale des soins intensifsTreatment in the NICUFrenchNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANADrug treatment;Non-drug treatmentPrenatal Adult (19+)NA2009-10-31T04:00:00ZJonathan Hellmann, MBBCh, MHSc, FCP(SA), FRCPC12.000000000000043.0000000000000794.000000000000Flat ContentHealth A-Z<p>Lisez au sujet de l’unité néonatale des soins intensifs. Le but de l’unité néonatale des soins intensifs est de permettre au bébé prématuré de se développer comme il l’aurait fait dans l’utérus.</p><p>Il existe plusieurs types et degrés d’intervention auxquels peuvent être soumis les bébés prématurés. Plus un bébé est prématuré, plus il est probable qu’il nécessite une forme d’intervention en raison de sa condition.<br></p><h2>À retenir</h2> <ul><li>Tous les traitements comportent risques et avantages. Bien souvent, les avantages l’emportent sur les risques.</li> <li>Les médecins connaîtront souvent le traitement approprié à un trouble donné grâce à la recherche. Mais il existe toujours une incertitude.</li> <li>Il arrive parfois qu’un traitement ne fonctionne pas. Dans ce cas, les fournisseurs de soins de santé et les parents doivent décider des étapes subséquentes.</li></ul>

 

 

Treatment in the NICU1834.00000000000Treatment in the NICUTreatment in the NICUTEnglishNeonatologyPremature;Newborn (0-28 days);Baby (1-12 months)NANADrug treatment;Non-drug treatmentPrenatal Adult (19+)NA2009-10-31T04:00:00ZJonathan Hellmann, MBBCh, MHSc, FCP(SA), FRCPC12.000000000000043.0000000000000794.000000000000Flat ContentHealth A-Z<p>Read about the Neonatal Intensive Care Unit (NICU). The goal of the NICU is to allow a premature baby to grow as they would have in the womb.</p><p>There are many types and degrees of intervention that premature babies may go through. The more premature a baby is, the more likely they will require some form of intervention due to their condition.</p><h2>Key points</h2> <ul><li>There are risks and benefits to all treatments, however the probable benefits often outweigh the risks.</li> <li>Doctors will often know the correct form of treatment for a certain condition because of research, however there is always a degree of uncertainty.</li> <li>In some cases, treatment may not work, at which point parents and health-care providers must make a decision about next steps.</li></ul><figure> <img alt="Preemie in isolette" src="https://assets.aboutkidshealth.ca/akhassets/Preemie_in_isolette1_EN.jpg" /> </figure> <h2>Recreating the environment of the womb</h2><p>As much as possible, the experience and treatments in the Neonatal Intensive Care Unit (NICU) are done to provide time so that a baby can mature as naturally as possible outside the womb. Often, the stay in the NICU is precautionary: once the baby has settled into their artificial environment, they are simply monitored while they catch up on the time that would have been spent maturing in the womb.</p><p>Simulating as much as possible the environment of the womb is a kind of treatment. Like the womb, the NICU is dark, quiet, and warm, and the baby is protected from knocks and infection. Depending on their degree of prematurity, a baby may require other support, particularly with breathing and cardiovascular issues. Premature babies may also require support for their body chemistry in some way. Frequently this may mean ensuring the right balance of fluids and electrolytes that the premature baby’s body cannot yet regulate on its own because of an immature kidney or gastrointestinal tract.</p><p>All these interventions may occur even though there is nothing “wrong” with the premature baby. Often, the only thing “wrong” with premature babies, especially those who are only a few weeks premature, is that they are in the wrong place and still need time to develop and adjust to the outside world.</p><p>The combination of all these treatments can be considered an “intensive care package” in that the benefits of each individual intervention may not be as apparent as the package as a whole. In other words, the sum of treatments in the NICU is often greater that the individual parts.</p><h2>Treating specific conditions</h2><p>Beyond creating an environment that will encourage premature babies to develop normally, treatments address distinct problems or conditions. Usually, treatment follows diagnosis. However, if doctors deem that the risk of waiting for a diagnosis outweighs the risks of beginning treatment, an intervention may begin right away even if a diagnosis has not been confirmed. For example, if an infection is suspected, the doctor will likely not wait the hours needed for a laboratory to confirm the infection and antibiotics, the usual treatment for infection, will begin right away.</p><p>This concept of risk versus benefit applies to all treatments. Although it is usually extremely small, all treatments carry some risk. However, the probable benefit of treatment often outweighs the risk of not doing anything.</p><h2>Group statistics and the individual premature baby</h2><p>When a premature baby has a certain condition, physicians often know the right course of treatment because of research. Over time, evidence has built up that for a particular condition, a certain treatment tends to work. But there is a measure of uncertainty: what generally works for the majority of patients, even the overwhelming majority, may not work in an individual case. It can be difficult to know whether a particular baby will respond to a certain treatment and how well.</p><h2>When treatment does not work</h2><p>The goal of treatment is to improve the condition of the baby. If a premature baby has an infection, the goal of the treatment, antibiotics, is to fight off the infection.</p><p>Sometimes, usually only in the more severely premature babies, treatment does not work and the prospect for success using further treatments is not good. In these cases, which are sad for all involved, the temptation may be to continue treatment anyway. These temptations are usually motivated by emotional considerations of the parents. In these situations, parents may feel a need to “do something” even though doing something will not make the premature baby well and may subject the baby to further risks and additional discomfort.</p><p>It must be remembered that treatment is not a goal unto itself. Rather, it is a method to try and reach the goal: improving the condition of the premature baby. The desire to continue treating a premature baby despite the overwhelming likelihood that the treatment will fail is understandable, given the circumstances. Parents want to feel that they did everything they could. They often feel that they could not live with the guilt if they did not do everything. Treatment decisions must be made in the premature baby’s best interest and, in some rare cases, the decision not to continue treatment may in fact be in the baby’s best interest.</p>https://assets.aboutkidshealth.ca/akhassets/Preemie_in_isolette1_EN.jpgTreatment in the NICU

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