CCRN Neonatal key terms

A fetal vessel connecting the pulmonary artery and the aorta that fails to close after birth, causing left-to-right shunting and pulmonary overcirculation; a common cause of heart failure and feeding difficulty in preterm infants.

A heart lesion in which pulmonary or systemic blood flow depends on a patent ductus arteriosus. Closing of the ductus after birth causes rapid deterioration, so the ductus is kept open with medication or stenting until surgery.

A continuous intravenous infusion that keeps the ductus arteriosus open when ductal-dependent heart disease is suspected. Watch for apnea, hypotension, fever, and jitteriness, and keep airway and ventilation support ready.

A severe lesion with an underdeveloped left ventricle and ascending aorta, so the right ventricle supplies the body through the ductus. Cyanosis and shock appear as the ductus closes; treatment is staged surgical palliation.

The aorta arises from the right ventricle and the pulmonary artery from the left, creating parallel circulations. Survival depends on mixing blood through a ductus, an atrial septal defect, or a balloon septostomy.

Pulmonary vascular resistance is high in the fetus; after birth, lung expansion and falling resistance increase pulmonary blood flow. If resistance stays high, blood shunts right to left and the infant becomes hypoxemic.

Oxygen saturation measured on the right hand (preductal) compared with a foot (postductal). A preductal reading higher than the postductal by roughly 5 to 10 percent suggests right-to-left shunting or coarctation.

Distress in preterm infants caused by surfactant deficiency and immature lungs, producing grunting, retractions, and a ground-glass chest radiograph that typically worsens over the first days of life.

Medication instilled into the trachea of infants with respiratory distress syndrome to lower surface tension, improve compliance, and reduce ventilator pressures. Watch for airway obstruction, desaturation, and bradycardia during dosing.

Noninvasive positive pressure applied throughout the respiratory cycle to keep alveoli open and reduce work of breathing in preterm infants with apnea, respiratory distress, or after extubation.

Lung inflammation and airway obstruction after a stressed fetus aspirates meconium. Infants may develop air leaks and persistent pulmonary hypertension and need suctioning, respiratory support, and gentle care.

Failure of pulmonary vascular resistance to fall after birth, causing right-to-left shunting and hypoxemia that seems worse than the lung disease explains. Managed with oxygen, inhaled nitric oxide, and sometimes ECMO.

Pauses in breathing longer than 20 seconds, or shorter pauses with bradycardia or desaturation, caused by an immature respiratory control center. Treated with caffeine and sometimes positive pressure support.

Chronic lung disease of preterm infants, defined by ongoing oxygen need at 28 days of life or 36 weeks postmenstrual age, related to ventilation, oxygen toxicity, and inflammation. May require prolonged respiratory and nutritional support.

Retained fetal lung fluid causing tachypnea, grunting, and mild hypoxemia in term or late preterm infants, usually clearing within a few days with supportive care and oxygen as needed.

Blood glucose below the screening threshold for the infant's age and risk factors, which can cause jitteriness, poor feeding, lethargy, or seizures. Treated with early feeding or intravenous dextrose and frequent rechecks.

Elevated unconjugated bilirubin causing jaundice; severe levels risk kernicterus. Treatment depends on age in hours and risk factors and includes phototherapy, exchange transfusion, and ensuring adequate intake.

Inflammatory bowel necrosis, mostly in premature infants, presenting with feeding intolerance, bilious emesis, abdominal distention, and blood in the stool. Requires stopping feeds, antibiotics, and sometimes surgery.

A venous hematocrit above roughly 65 percent, which thickens the blood, slows flow, and can cause hypoglycemia, jaundice, and poor perfusion. Partial exchange transfusion is used for symptomatic infants.

A gradual fall in hemoglobin and red cell mass from low erythropoietin, blood sampling, and rapid growth, causing tachycardia, poor weight gain, and apnea. Treated with transfusion, iron, or erythropoietin.

Thickening of the pyloric muscle causing projectile, nonbilious vomiting in the first weeks of life. Infants may become dehydrated with hypochloremic, hypokalemic metabolic alkalosis and need surgical repair.

A sudden fall in urine output (under 1 mL/kg per hour) with rising creatinine from poor perfusion, nephrotoxins, or obstruction. Care focuses on fluid balance, avoiding nephrotoxins, and correcting the cause.

Deficient thyroid hormone present at birth, often with few obvious signs, that threatens brain development. Found by newborn screening and treated promptly with levothyroxine, with ongoing monitoring of levels and growth.

A platelet count below 150,000 per microliter, common in sick or premature infants from sepsis, placental problems, or immune destruction. Severe counts raise bleeding risk and may need platelet transfusion.

Bleeding into the germinal matrix and ventricles of premature infants, graded I to IV. Severe grades cause hydrocephalus, seizures, and poor neurodevelopment; prevention focuses on stable blood pressure and gentle handling.

White matter injury near the ventricles from ischemia or infection in premature infants, often seen on later ultrasound and linked to spastic diplegia and other motor problems.

Brain injury from reduced oxygen and blood flow around birth, staged by severity, with low tone, seizures, and feeding problems. Cooling started within hours may limit the damage.

Controlled cooling to about 33.5 degrees Celsius for 72 hours in infants with moderate to severe hypoxic-ischemic encephalopathy, started within 6 hours of birth. Requires close monitoring of heart rate, glucose, and coagulation.

Withdrawal signs in newborns exposed to opioids or other substances before birth, including tremors, high tone, poor feeding, and inconsolable crying. Managed with comfort care and, when needed, medication guided by scored assessments.

Abnormal electrical brain activity that can look subtle in newborns, such as lip smacking, cycling movements, or apnea, rather than rhythmic convulsions. Needs EEG confirmation and treatment of the underlying cause.

Stretch injury to the nerves of the arm, often after shoulder dystocia, causing weakness or an asymmetric Moro reflex. Most infants improve with gentle positioning and range-of-motion therapy.

Strategies that reduce stress and support brain development in premature infants, such as clustered care, protected sleep, dim lighting, and positioning that supports flexion and self-regulation.

Use of validated behavioral and physiologic scales, such as crying, facial expression, and heart rate, to detect pain in infants who cannot report it, guiding comfort measures and analgesia during procedures.

Bacterial infection in the first days of life, often from group B streptococcus or E. coli, presenting with temperature instability, respiratory distress, and poor feeding. Treated promptly with antibiotics after cultures.

Conditions that keep oxygen use and calorie burning for heat production at a minimum, achieved with warmers, incubators, and hats. Prevents cold stress, metabolic acidosis, and hypoglycemia.

A score at 1 and 5 minutes of heart rate, respiratory effort, muscle tone, reflex irritability, and color that describes newborn condition and response to resuscitation; it does not decide whether resuscitation is needed.

Care that treats parents as partners and decision-makers, supporting their presence, teaching them their infant's cues, and adapting routines to their needs and culture.

Obtaining permission after explaining a procedure's purpose, risks, benefits, and alternatives in plain language, confirming understanding, and documenting the discussion with the person authorized to consent.

Care for infants with life-limiting conditions that addresses pain, feeding, breathing, and family grief alongside curative treatment, with goals set and revisited together with the family.

Birth weight below the 10th percentile for gestational age, which raises the risk of hypoglycemia, polycythemia, meconium aspiration, and hypothermia, and requires close glucose and temperature monitoring.