The monitoring of critically ill neonates

Present-day neonatal intensive-care demands minute-by-minute knowledge of many different physiological parameters in order to anticipate, and hopefully avoid, crises which may adversely affect the individual's potential. Machines monitoring temperature, respiration and apnoea, heart-rate and rhythm, inspired oxygen, arterial oxygen and transcutaneous oxygen, blood-pressure and transcutaneous carbon dioxide are physically and electronically complex and yet they will have to be understood by clinicians and nurses without more than minimal training in their use. This paper assesses the clinical needs of the neonatal unit and discusses the available monitors from the clinician's point of view. The role of trend monitors, and monitoring of sick infants during transport from hospital to hospital are also discussed. If these monitors can be used correctly by medical and nursing staff, valuable time can be gained for the nursing of the baby. Failure of correct application may make life more dangerous for the sick or preterm infant.