Neonatal-Perinatal Medicine Clinic Descriptions

Duke Intensive Care Nursery
This 50-bed neonatal intensive care unit provides care for more than 800 infants each year.

• Renovated unit opened in 2002 with 50 NC level IV beds.
• Scheduled bed expansion to 65 ICN beds.
• Over 800 admissions/year from southeast and worldwide.
• ECMO, high frequency ventilation, inhaled nitric oxide, hypothermia and perinatal asphyxia.
• Focus on extremely low birth weight patients and their families.
• Expertise in care of extremely low birth weight infants, preemie and infants with persistent pulmonary hypertension and congenital diaphramatic hernia.

Contact: Ronald Goldberg, MD

Duke Transitional Care Nursery
This "step-down" unit helps transition infants from the ICN to home.

• Twelve convalescent beds.
• Two "Care-by-Parent" rooms are used to facilitate the transition from hospital to the home environment by allowing parents a 'trial run' in caring for their infant in a secure environment.
• Providers in the TCN take a multi-disciplinary, developmental care team approach. Physicians, nurse practitioners, nurses, therapists, dietitians, lactation consultants, and family members work together in developing a manageable home program suitable for the individualized needs of the infant.
• Convalescent care of extremely low birth weight infants, chronic lung disease of infancy, feeding problems, infants with non-acute surgical, neurosurgical, and sub-specialty medical issues.

Contact: William F. Malcolm, MD

Neurodevelopmental Follow-Up Clinic
The Neurodevelopmental Follow-Up Clinic provides close monitoring of infants who are considered to be high-risk, including infants born prematurely or at very low birth weight. The goals of follow-up are to identify disabilities as early as possible to initiate intervention and parental education as early as possible, to monitor services provided, and to assess further needs of the infant.

Duke Special Infant Care Nursery
The Duke Special Infant Care Nursery is also known as the 5800 Nursery and features:

• Seven Level-II beds for neonates not requiring intensive care.
• A focus on preparing family and infant for discharge home (short stay).
• A feeding team including family caretaker, bedside nurse, lactation specialist, and occupational and speech therapists.

Contact: William F. Malcolm, MD

Durham Regional Hospital Special Care Nursery
The Special Care Nursery at Durham Regional Hospital provides care for acutely ill and convalescing infants. Infants who no longer require Level III-IV care, may be transferred to this nursery for their convalescent period. Infants requiring surgery or sub-specialty medical care are routinely transferred to a local Level III unit. Duke University's Division of Neonatology manages the 18-bed unit. The medical director is Margarita Bidegain, MD, and Susan Izatt, MD is the Associate Director. Both Dr. Bidegain & Dr. Izatt rotate through the Duke Level IV intensive care nursery.

Special care services offered in the nursery include:

• Short term mechanical ventilation, CPAP, surfactant administration, hyperalimentation, PICC lines and care for infants with ostomies.
• Developmentally emphasized care of growing premature infants.
• Lactation support services, and a breastfeeding room.
• Physical, speech and occupational therapy.

Contact: Margarita Bidegain, MD

Alamance Regional Medical Center Special Care Nursery
The Special Care Nursery at Alamance Regional Medical Center (ARMC) is the newest facility in the Duke Health System's neonatal service. The new unit includes 12 beds and state-of-the-art technology and provides care for the acutely ill and convalescing infants.

Infants requiring surgery or sub-specialty medical care are transferred to a local Level IV unit. Special care services offered in the nursery include, but are not limited to: electronic documentation, transcutaneous billirubin readings, NCPAP, short term mechanical ventilation, surfactant administration, transcutaneous C02/02 monitoring, hyperalimentation, percutaneous central venous lines, and care of the growing infant.

Contact: Hugo A. Navarro, MD

Special Infant Care Clinic (SICC)
The Special Infant Care Clinic (SICC), is a multidisciplinary medical and neurodevelopmental follow-up clinic for high risk infants. Clinic patients have either graduated from our Intensive Care Nursery or are referred by a well child care provider in the community. The clinic team is comprised of a neonatologist, pediatrician, child psychologist, physical therapist, occupational therapist, speech therapist, social worker and nurse clinician. An occupational therapist and nutritionist are also available for consultation. The main objectives of our clinic are to:

• assist the community well child care physician in providing early post discharge medical care and coordinating multiple subspecialist involvement for infants with complicated neonatal courses and chronic medical problems, and to facilitate the transition of total care of the chronically ill child with disabilities to the well child care provider by two to three years of age.
• monitor the neurodevelopmental progress of infants at significant risk for developmental problems, and when an abnormality is detected, to make appropriate referrals for intervention.
• assess whether the neurodevelopmental outcome of a particular child is consistent with his/her neonatal course, and if not, to initiate further diagnostic evaluation and appropriate referrals.
• train future well child care providers (pediatric and family practice residents) and neonatology fellows in neurodevelopmental assessment of high risk infants and post-discharge medical care of the intensive care nursery graduate.
• monitor and analyze the outcome of former critically ill high risk infants treated with new medications and technologies in order to improve medical care and developmental outcome of newborn infants in the future.

Neonatal-Infant Palliative Care Program (NIPCP)
The Division of Neonatology offers this family-centered program for newborns and infants diagnosed with serious life-threatening conditions or overwhelming illnesses that are no longer responding to curative care. During very stressful times, this program supports and enhances the traditional care offered to newborns and infants by promoting quality of life in accordance with the families’ values and desires. This is accomplished by optimizing comfort care, facilitating communication between caregivers and parents, and helping families define goals. The program may begin in the prenatal period and continues during the first year of life.