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NEONATAL INTENSIVE CARE UNIT

Neonatal Intensive Care Unit (NICU) is for the care of sick newborns and premature babies as small as 500 gms or delivered as early as 24 -25 weeks of pregnancy. We have the most sophisticated and state of the art gadgets in NICU. Facilities are comparable to the best NICUs in developed world.

The Neonatal ICU at ANKUR is designed strictly according to the guidelines of National Neonatology Forum for level III units & accreditation procedure is under way. The NICU is divided in to 3 units.

1st unit (Critical care): 8 bedded NICU equipped with latest and highest model of Phoenix Neonatal open care systems, 7 Siemens servo 300 A ventilators, 1 SLE 5000 High frequency ventilator, SLE INOSYS inhaled nitric oxide delivery system, L&T multiparameter monitors, L&T infusion pumps. It is for critically sick newborns that need highly specialized medical or surgical care. The medical and nursing supervision and care is at the highest intensity here. Very premature babies, babies with serious infections, lung and heart conditions, and those with major birth defects involving the brain, heart, lungs and kidneys would be admitted here. The Critical Care service for newborns at ANKUR compares with the best in the world in terms of 'quality of care'. The equipment used the level of expertise and training of the neonatologists, pediatricians and nurses in our NICU is comparable to any center of excellence in the developed countries.

There are a few features of our NICU which are unique and available in very few centers in India. The first is "High Frequency Oscillators", This is one of the most sophisticated types of ventilators (artificial breathing machines) which delivers breaths to the baby at the rate of around 400 - 600 breaths per minute as compared to 40 - 60 breaths given by a conventional ventilator. This machine is ideal for rescuing babies who are not responding to conventional modes of ventilation and it can be used as a first line therapy for babies with meconium aspiration, air leaks and severe HMD with very hypovolemic lungs. High frequency ventilation is gentler for the lungs. We have SLE 5000 high frequency ventilators, imported from the United Kingdom; These require a high degree of expertise to operate.

The second feature is the availability of a special type of gas. This medical gas is called "Nitric Oxide". This gas has specific uses in the NICU in babies suffering from high blood pressure in their lungs, in medical parlance known as 'pulmonary hypertension'. Combined with the High Frequency Oscillators, inhaled nitric oxide delivered through a special delivery system into the baby's lungs helps relax the blood vessels in the lungs, thereby improving oxygen uptake. Inhaled Nitric Oxide treatment is available in very few centers in India

2nd unit (Premature Nursery): Equipped with 12 Phoenix open care systems it is for premature babies. They are shifted here once they are off ventilator support. Many prematurely born and very low birth weight babies (less than 1500 grams at birth) are cared for in this unit in special warmers which have a carefully controlled temperature. They may need to stay for several weeks till they are mature enough to feed from their mothers and maintain their body temperature

3rd unit (High dependency unit): Equipped with 10 Phoenix open care units, is for term babies & babies less than 2 months of age once they are off intensive care and are in recuperating phase. Once babies are off life support and recovering from illness, or problems related to pre maturity, they are transferred to the High Dependency Unit where they are nursed and monitored continually. Such babies are typically off oxygen or breathing support and still on artificial tube feeding and on intravenous fluids and antibiotics.

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All three units have separate HVAC (air conditioning), The NICU is supported by central suction, oxygen, compressed air supply, uninterrupted power supply, portable x-ray, portable USG & Echo/colour doppler and 24 hours highly equipped lab with ABG, Electrolytes & blood culture.

When newborn babies fall ill, they require specialized care, with equipments and drugs in ways much different from the way adults are treated. Not only are minute doses of medicines required, the equipments like ventilators, etc., are designed specially to suit the small lungs of the babies. When babies are born in much advance of the date on which they were due, they are all the more smaller, demanding more care, and more prone to infections.

Top of the line Siemens and SLE Neonatal Ventilators are used to support respiration to small babies without harming the lungs and blood gas analyzer is available to monitor oxygen levels in the blood.

The neonatal team continuously supervises the various parameters including the baby's vital signs like heart rate, respiratory rate, blood pressure, oxygen saturation, and how hard the baby is working to breathe, using an array of monitoring equipments like multi Para monitors, pulse-oxymeters, ECG monitors, NIBP ( Non Invasive Blood Pressure Monitoring).

Infusion pumps allow precise control of fluids and drugs being administered to babies. Cold Light source is used for accessing the tiny arteries and veins of the babies. For imaging, we use the in house Doppler and Radio Imaging equipments.

The ICU is equipped with the latest equipment to measure and treat jaundice in newborn babies. LED phototherapy is the most advanced phototherapy machines anywhere in the world and these are available in our NICU. In a rare case when bilirubin in blood reaches threatening levels; whole blood needs to be replaced by healthy blood, in a procedure called Exchange Transfusion – a procedure for which babies are referred frequently to ANKUR

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Nursing care 
The prime reason for successful outcome of virtually all critically ill babies in our NICU is the excellent work and support of our newborn nursing staff. All the nurses posted in the NICU are highly trained and undergo regular in-house training and refresher programmes which include Neonatal Advanced Life Support [NALS course] and Neonatal Resuscitation.
Feeding Room for Mothers and Total Parenteral Nutrition Service 
We have a special room for mothers to come to the NICU to breast feed their babies in total privacy under the supervision and guidance of trained newborn nurses. The Total Parenteral Nutrition Service is provided for those newborns who cannot be fed milk and require special fluids to be administered through veins. The special fluids consisting of glucose, water, electrolytes and other nutrients are prepared under a special sterile ' Laminar Flow System' with an absolutely sterile technique. Trained pediatricians and nurses prepare these fluids under guidance from senior consultant neonatologists.  
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