Design of ICUs

To the Editor.— Most newborn intensive care units (NICUs) today stand as monuments to the technology and efficiency that dramatically improved survival of premature newborns during the last two decades. Beginning as small "premie nurseries" which held five or six newborns per room, NICUs evolved in the late 70s and the early 80s into large, bright, noisy, high-tech wards housing 30, 40, or even 60 newborns. State building codes and recommendations for NICU design were formulated during this era which emphasized cleanliness and efficiency, but largely neglected the impact of the NICU environment on the premature newborns themselves.