Recovery of the neonate after open heart surgery: strategies for preparing the NICU

Certain congenital heart defects require surgical intervention if the neonate is to survive. In some cases, the correction involves open heart surgery requiring cardiopulmonary bypass. A Level III NICU implemented a program to prepare itself to accept neonates directly from the OR for recovery. The benefits of caring for these infants in the NICU include staff's expert knowledge of neonatal anatomy and physiology, experience in supporting the family, and an awareness of the developmental needs of the neonate. A needs assessment of the NICU identified areas to address in preparation for this initiative. An extensive program was implemented to strengthen staff knowledge of pathophysiology, enhance technical skills, and purchase necessary equipment. This investment has resulted in close to 100 infants successfully recovered in the NICU. With meticulous planning, the NICU can be the unit of choice for providing excellent care to these critically ill neonates and their families.