Technique and protocol for bedside neuroendoscopic lavage for post-hemorrhagic hydrocephalus: technical note

Area of Science:

• Neurosurgery
• Neonatal Medicine
• Pediatric Neurology

Background:

• Post-hemorrhagic hydrocephalus (PHH) is a serious complication in preterm neonates.
• Traditional neurosurgical interventions for PHH pose significant risks for fragile preterm infants.
• Challenges include extubation, temperature instability, and risks associated with operating room transport.

Purpose of the Study:

• To describe a novel bedside neuroendoscopic lavage (NEL) technique.
• To facilitate safe and timely treatment of intraventricular blood in PHH within the neonatal intensive care unit (NICU).

Main Methods:

• Development and implementation of a bedside NEL procedure.
• Performed within the NICU environment to minimize patient transport risks.
• Focus on addressing intraventricular hemorrhage in preterm neonates.

Main Results:

• Successfully adapted NEL for bedside application in the NICU.
• Facilitated timely intervention for PHH in a high-risk neonatal population.
• Mitigated risks associated with traditional OR procedures for these fragile infants.

Conclusions:

• Bedside NEL is a feasible and safe neurosurgical technique for PHH in preterm neonates.
• This approach enhances treatment accessibility and timeliness in the NICU.
• It offers a viable alternative to overcome challenges of OR-based procedures for vulnerable infants.