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Neonatology


Children’s Hospital Central California offers Regional Neonatal Intensive Care* - the highest level of care available for neonates and infants between Los Angeles and the Bay Area - in its 88-bed Neonatal Intensive Care Unit (NICU) which includes 21 private and semi-private rooms. Children's Hospital physicians and staff provide Intermediate Neonatal Intensive Care** for neonates and infants in its NICUs at partner hospitals in the region - St. Agnes Medical Center, Fresno (8-bed community Level III unit and 6-bed Level II unit), Mercy Medical Center, Merced (8-bed unit) and Central Valley General Hospital, Hanford (4-bed unit).***

Children’s NICU provides 24 hour coverage by board certified neonatologists with consultations from medical and surgical subspecialists. We see almost 1,000 cases and have 20,000 patient days annually. Our outcomes with neonates under 1,500 grams is consistently better than other Level III centers in the state. Our adjusted mortality rate for this population is 9.2% compared to a 12.2% California average.

Our ‘case-mix index’ (a number that compares the severity of different populations), is the fourth highest of all 37 NICUs in a nationally comparative database. In other words, on average, the babies that come to Children’s are more seriously ill than those that come to 33 of the other NICUs, and yet we have better results than all of our regional peers.



Satellite NICUs

Children’s Hospital Central California owns and operates a network of satellite NICUs in regional
hospitals, providing the opportunity for some families with premature babies to receive treatment closer to home.

These satellites are located in:

Level II Neonatal Care including treatment of:

  • Prematurity, Sepsis
  • Hyperbilirubinemia
  • Feeding difficulties
  • Respiratory Distress
  • Hypoglycemia

We provide Resuscitation Teams made up of Extended Practice trained RN’s and Respiratory Care Practitioners who attend all high risk deliveries. Depending on their clinical status, those patients are stabilized on site and either prepared for Critical Transport via our Medical Transport Team to Children’s or managed within the Level II satellite. Many infants remain in the satellite for the duration of their inpatient stay, receiving high quality patient care close to their own homes. Physicians who are on staff at Children’s care for the patients in the satellites.

The satellites also will receive back those initially critical patients who were transported out at birth so
that they can be closer to home for the remainder of their stay for continuing care.

In November 2013, Children’s Hospital expanded our unit at Saint Agnes to include a community Level III NICU. This much-needed upgrade allows more babies delivered at Saint Agnes who require a higher level of care to stay in the same hospital as their mothers.   

Services Offered & Conditions Treated

These are some of the most common services available:

  • Prematurity
  • Ventilatory support
  • Cardiovascular support
  • Respiratory distress syndrome
  • Congenital abnormalities
  • Sepsis
  • Genetic testing
  • Nitric Oxide Therapy
  • Intravenous therapy
  • Cardiac anomalies
  • Diaphragmatic hernias
  • Heart disorders
  • Kidney disorders
  • Gastrointestinal disorders
  • Liver disorders
  • Genetic disorders and malformation
  • Hematologic diseases
  • Infections
  • Neurological/neurosurgical conditions
  • Primary metabolic defects
  • Surgical conditions
  • Developmental and behavioral program
  • Complex birth defects
  • High risk medical conditions
  • Birth apnea
  • Hyperbilirubinemia
  • Patent Ductus Arteriosus
  • Chronic Lung Follow-up Clinic
  • High-Risk Infant follow-up program

Ronald McDonald House

  • Provides a place to stay for parents from outside the Fresno/Madera area whose children are patients.

Multidisciplinary Services

*Regional Neonatal Intensive Care is the highest rating by the California Children’s Services (CCS) program and denotes NICUs that offer the capability of providing a full range of neonatal care services including neonatal surgery, for severely ill neonates and infants. Regional NICUs provide support to Community and Intermediate NICUs in its region that includes, but is not limited to, professional education and consultation.

**Intermediate Neonatal Intensive Care nurseries are located within a CCS-approved Pediatric Community, General Community or Special Hospital that has the capability of providing neonatal care services for sick neonates and infants who do not require intensive care but require care at a level higher than provided in a general nursery. Such infants may include, but are not limited to, infants requiring intravenous medication, exchange transfusion, nasogastric tube feeding, parenteral nutrition, oxygen therapy and short-term ventilatory assistance.

***NICUs also receive specialty rankings by national and international medical organizations. According to the Vermont Oxford Network (VON), a nonprofit voluntary collaboration of healthcare professionals of over 900 NICUs around the world, Children's Hospital Central California's NICU is a Level IIIC , the organization's highest ranking, meaning the Hospital has no restrictions on ventilation and performs major surgery including open-heart surgery for neonates. According to the American Academy of Pediatrics, Children's NICU is a Level IIID, the organization's highest ranking, meaning the Hospital offers major surgery, surgical repair of serious congenital heart anomalies that require cardiopulmonary bypass, and/or ECMO for medical conditions.

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