The Neonatal Intensive Care Unit at CHONY
Respiratory Care * ECMO* Neonatal Nutrition* The Allen Pavilion

As a segment of New York Presbyterian Hospital, The Children's Hospital of New York at Columbia-Presbyterian is a part of one of the world's principal centers for patient care, biomedical research, and medical education. For more than a century, it has constructed a reputation as one of the nation's foremost pediatric facilities. Today, the hospital's facilities and staff can fulfill the special needs of children from infancy to adolescence, in every medical and surgical discipline. The Children's Hospital of New York is proud of its dedication to family-centered care. The staff of specialists, doctors, nurses, therapists, and social workers understands that a child's illness involves the entire family.

The NICU
The Neonatal Intensive Care Unit (NICU) at Children's Hospital of New York specializes in providing high quality care for sick and premature newborns. We realize that the hospitalization of a newborn child is a stressful experience. With this in mind, we are dedicated to supporting you through your experience. Remember, we do not just care for your baby---we are committed to caring for you and your family.
Children's Hospital of New York is the hub of the Regional Perinatal Network, which links hospitals throughout the tri-state area. Through this network, high-risk infants are transported to Babies' neonatal intensive care unit by helicopter or mobile intensive care.

The Neonatal Intensive Care Unit at Children's Hospital of New York is noted for its contributions to the field of neonatology. Early neonatologists, perinatologists, and obstetricians collaborated in research, which shaped the field of neonatal care as we know it; including development of the APGAR score and use of Nasal Prong CPAP.

Respiratory Care
The neonatal intensive care unit at the Children's Hospital is skilled in a wide variety of techniques for support of the neonate with respiratory distress. In addition to the neonatology faculty and support staff, there is a full time neonatal anesthesiologist (Dr. Jen Wung) who assists with the care of infants needing respiratory support. Our intensive care unit has been recognized by the National Institute of Health for its extremely low incidence of chronic lung disease.

ECMO
Extracorporeal membrane oxygenation (ECMO, or extracorporeal life support) uses a constellation of biomedical devices that reproduce the functions of the heart and lungs. This technology provides sustained life support for selected newborn and pediatric patients; these children are often suffering from overwhelming respiratory or cardiac failure which has proved refractory to other treatments. For newborns, the therapy is not unlike returning the infant to his mother's placenta, for a more gradual transition to breathing air.

Since 1982, the Center for Extracorporeal Life Support at the Children's Hospital has been directed by Dr. Charles Stolar in the Division of Pediatric Surgery. The Center was the third in the world to successfully support a neonate. More than 2,500 infants have been referred as potential ECMO patients from 47 institutions throughout the Tri-State area and the Mid-Atlantic region. To date, 175 infants and a smaller number of older children have been treated with ECMO, of whom 84% are at home with their parents.

However, ECMO is only part of the respiratory care strategy in the Neonatal Intensive Care Unit, which is itself a unique resource. Respiratory failure is the most common cause of death and complications in the newborn. The Neonatal Intensive Care Unit at Children's Hospital has earned an international reputation for excellence in respiratory care, which rests on our results: the frequency of chronic lung disease in premature infants treated in our unit is the lowest in the United States. We have a particular interest in newborns with congenital diaphragmatic hernia. By designing a protocol focused on the gentle support of the fragile lungs of these babies, we have been able to turn a mortality rate of 50% into a survival rate of 92% for patients with this condition.

Neonatal Nutrition Support Services
Director:Sudha Kashyap, MD
Nutritionist: Joanne Carroll, RD

For decades Children's Hospital of New York, has been in the forefront of pediatric/neonatal rehabilitation. Major contributions have been made by our staff to fields of neonatal parenteral and enteral nutrition.

In our neonatal unit the Nutrition Support Service is strongly represented on a daily basis. There is a neonatal nutritionist and a neonatologist that specializes in nutrition research.

The nutritionist is an integral part of the neonatal team. She rounds daily with the Attendings, Nurse Practitioners, and Residents to offer recommendations to optimize the nutrition care of the sick neonate. The nutritionist also provides in-service to the house staff on theory and rationale of nutrition principles.

Nutrition assessments, goals and plans are evaluated on a weekly basis for neonates on parenteral nutrition and monthly for enterally fed infants.

The Allen Pavilion
The Allen Pavilion of the New York Presbyterian Hospital is a 206 bed facility that was opened in 1989 to provide in-patient medical services to the Heights-Inwood and Southern Riverdale communities of Northern Manhattan and the Northwest Bronx. The pavilion is now the hub of a network of community outreach clinics that offer a full range of primary care medical services to this area. The hospital's active obstetrical service now delivers over 2500 infants per year; sick newborns are cared for on-site in the Level 2 NICU or are transferred to the tertiary referral facility (Babies Hospital) at the 168th Street campus.

Newborns at the Allen Pavilion are cared for by staff of skilled, experienced registered nurses and ancillary health professionals, as well as three full-time physicians, including one general pediatrician (Dr. Pran Saha) and two neonatologists (Dr. Francis Akita and Dr. David Bateman). In addition to providing the highest quality medical care possible, the staff's goal is maintain the "user-friendly" community-hospital ambiance that has helped the Allen Pavilion become an important component of everyday life in these neighborhoods.