The neurointensive nursery: concept, development, and insights gained

Area of Science:

• Neonatal Neurology
• Neurocritical Care
• Pediatric Neurological Disorders

Background:

• Advancements in therapeutic hypothermia, neuroimaging, and neuromonitoring have ushered in a new era of neonatal brain-focused care.
• Hypoxic ischemic encephalopathy (HIE) management has improved, necessitating specialized care models for at-risk neonates.

Purpose of the Study:

• To describe the development and model of the first neurointensive care nursery (NICN).
• To establish a comanagement approach for neonates with neurologic risk factors.
• To optimize management, prevent secondary brain injury, and maximize long-term outcomes in neonates.

Main Methods:

• Multidisciplinary team comanagement including neurologists, neonatologists, and specialized nurses.
• Close monitoring and management of temperature, blood pressure, oxygenation, carbon dioxide, and glucose levels.
• Integration of early developmental interventions and physical/occupational therapy assessments.

Main Results:

• The NICN model is designed to optimize evidence-based care for infants at risk of neurologic injury.
• Ongoing trials in hypothermia and neuroprotection are expected to introduce new treatments.
• Emerging technologies like functional MRI and genomic approaches may enhance clinical protocols and precision medicine.

Conclusions:

• The NICN model represents a significant step towards comprehensive, multidisciplinary neurocritical care for neonates.
• Long-term follow-up data are crucial to validate the enduring benefits of the NICN/Neuro-NICU model.
• Advances in neurocritical care enhance family counseling and the provision of information regarding infant prognosis.