Respiratory Therapy

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.

Oxygen Therapy

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.

Diagnostics

The RT staff will draw, analyze, and report all blood gases. We also

assists in drawing labs from indwelling catheters and/or puncture sites.

Hemodynamic Monitoring

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.

Pneumocardiogram (ALICE)

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