A New Horizon

Neonatal Intensive Care Unit (NICU) is a specially equipped nursery where critically ill and unstable infants receive diagnostic, therapeutic and life support care for a wide range of illnesses and conditions. NICU is for those infants who are preterm, have low birth weight, or perinatal problems, or congenital abnormalities, respiratory disorders, neuromuscular disorders and for those who have undergone any surgery.Physiotherapy is a part of the services delivered by the interdisciplinary team in the NICU. It is a well-established practice and has become an acknowledged and integral part in the management of newborns and sick infants in NICU with respiratory issues. However, this is not the only area in which physiotherapy has a role. Physiotherapy is also indicated in neonates with neurological and orthopedic issues. The role of respiratory physiotherapist is of vital importance in the NICU, though recognised and practiced abroad widely, it is new in Indian set ups and we here are at KEM HOSPITAL PUNE NICU are one of the firsts and only unit to have such trained physiotherapists dedicated entirely to neonatology respiratory management. Respiratory physiotherapy commonly includes techniques like percussion, vibration, positioning for postural drainage and airway suctioning. It is useful for the maintenance of a clear airway, as also to re-expand collapsed segments of the lungs, maintain adequate levels of oxygenation, facilitate early weaning, and reduce the probabilities of reintubation.

In NICU unit of KEM, all elective extubations are performed solely by physiotherapists according to the UNIT protocols. Apart from this, they independently work on the ventilatory settings and ventilatory management of sick premature neonates of birth weight as low as 500gms. They are thoroughly trained with invasive as well as non-invasive ventilation which is extensively used in the unit and also neonatal resuscitation. For neuromuscular dysfunction, common therapeutic strategies for neuromuscular physiotherapy includes early intervention, positioning, skin to skin holding (Kangaroo Mother Care), therapeutic handling, orofacial stimulation, parent education for feeding, dressing, positioning of infants for sleep, play and interaction. These developmental strategies are beneficial for the promotion of posture and movement appropriate to gestational age and medical stability, modulate sensory stimulation in the infant's NICU environment, promote behavioral organisation and physiological stability, foster infant-parent attachment.

We at NICU KEM HOSPITAL, Pune, headed by Dr. Umesh Vaidya and under the guidance of two senior consultants Dr. Sandeep Kadam & Dr. Tushar Parikh, have two such dedicated physiotherapists in the team. Dr. Shikha Ganjoo & Dr. Gauri Dhanorkar are fully trained, experienced and competent in neonatal speciality leading from the front assuring the best services practiced nowhere in any other setup.