Selection criteria in the NICU: who should get effective critical care?

This paper discusses criteria for admission to the Neonatal Intensive Care Units (NICU). In India there is a severe shortage of NICUs for effective critical care and even government medical colleges do not have full-fledged NICUs. Babies with certain medical conditions have very poor chances of survival even with intensive care. Appropriate selection and referral of infants to the NICU is very important for medical, social and ethical reasons. Formulating selection criteria for admission to NICUs can cut down the number of infants unnecessarily admitted to these units, increase the availability of this special care to those who really need it, maximise the efficient use of resources and reduce the emotional and financial burden on parents whose children will not benefit from intensive care. Certain conditions can be managed effectively without admission to an NICU. Excessive anxiety and false optimism of parents can be addressed by forming a clinical ethics committee in every institution.