Glossary
ABR: Auditory Brainstem Response – a type of hearing test that tries to send signals along the auditory nerve and then observe the response to them in the brain. Used for babies who can’t otherwise indicate they’ve heard something.
ALTE: Apparent Life Threatening Event – In Dorrie’s case, these are caused by a combination of her reflux and her lung disease. Her lung disease has made her airway very reactive, meaning it overreacts to stimulation. When she refluxes it can cause her to have a laryngospasm and bronchospasm (her vocal cords and bronchial tubes block off her airway to protect it). This is good in that it prevents food from entering her lungs and bad in that it also prevents oxygen from getting in too! During the ALTE she turns blue and her heart rate drops – hence the colloquial term “death spells”.
BPD: Bronchopulmonary Dysplasia – a disease caused by the scarring and tissue trauma resulting from mechanical ventilation. It reduces lung capacity and makes gas exchange (oxygen/carbon dioxide) difficult among other things. The only “cure” is to manage symptoms as you wait for the growth of healthy lung tissue (the lungs continue to grow until age 7, 8 or even 12 according to some sources).
CLD: Chronic Lung Disease – Often used to mean the same thing as BPD, though for some reason there seems to be a different diagnosis for using this term. BPD = requiring oxygen for 4 weeks post birth, CLD = requiring oxygen after 36 weeks gestation.
CF: Cystic Fibrosis – one of many diseases looked for on the state mandated newborn screen
Desat: Short for desaturation – a drop in the oxygen level in the blood, which in Dorrie’s case is typically due to her not receiving enough oxygen (e.g., because the nasal cannula that delivers her oxygen is out of position), because she is upset or stressed, or because she is having an apnea epsiode. On her monitors, her desaturation alarm is typically set for 84%.
GER: Gastro-esophageal reflux – when food comes back up the esophagus, either all the way (spit-up) or just partway. In adults, acid reflux tends to cause heartburn, and babies can experience pain and discomfort from the acid and non-acid reflux, along with more serious problems like aspiration.
MSSA: methicillin-sensitive Staphylococcus aureus – Staph bacteria that are sensitive to antibiotics. As opposed to MRSA which is causing all the panic lately.
NNP: Neonatal Nurse Practitioner – in this case, a nurse (with extra training) who essentially functions as a primary care physician for the babies. She places central lines, does exams, writes orders and prescriptions and diagnoses conditions.
PDA: Patent Ductus Arteriosus – when in utero, the fetus has a vessel that connects the aorta and the pulmonary artery. This should close automagically when the baby is born and begins to breathe normal air. In preemies, especially very young ones, this doesn’t often happen. The open duct causes problems with oxygenation and circulation among other things.
PPHN: Persistent Pulmonary Hypertension of the Newborn – sometimes, the pulmonary arteries can constrict, causing the pressure in them to rise. This forces the heart to work harder to get blood through them and makes it harder for the body to oxygenate itself. If this condition persists, it can cause changes to the heart muscle and eventually cause the right half of the heart to fail. More often seen in term babies, babies with BPD can develop it too, and it’s a very serious condition.
ROP: Retinopathy of Prematurity – the eyes are one of the last organs to develop and babies born earlier than 34 or 36 weeks are born with their eyes still very immature. It’s thought that exposure to way more oxygen than the baby would be getting in utero is what causes the developing blood vessels in the eyes to go crazy. Left unchecked they can cause the retinas to detach and eventual blindness (this is why Stevie Wonder is blind). PLUS disease is a specific (bad) condition of the blood vessels.