Review article

Abstract

Since the early 1960s, neonatal intensive care units (NICUs) for critically ill newborn infants have been developed both to reduce neonatal morbidity and mortality rates and to improve the long-term prognosis for sick neonates. With the implementation of intensive care techniques for neonates, factors known to be associated with neonatal morbidity and mortality and with later neurologic, intellectual, and physical handicaps should be anticipated and thus prevented or at least promptly detected and corrected. These factors include birth asphyxia, hypoxemia, respiratory and metabolic acidosis, hypotension, hypothermia, hyperbilirubinemia, starvation, dehydration, hypoglycemia, hypocalcemia, hemostatic abnormalities, and infection. The "hands off attitude toward low birth weight (LBW) newborn infants (birth weight under 2500 grams) prevalent during the 1940s and 1950s has been modified with the advent of NICUs. A better understanding of the pathophysiology of many disease processes affecting high-risk · newborn infants has permitted Institution of gentle but active Intervention to prevent or manage abnormalities. Such Intervention includes provision of a neutral thermal environment; monitoring of blood pressure, central venous pressure, heart rate, and