El-Dib, M;
Abend, NS;
Austin, T;
Boylan, G;
Chock, V;
Cilio, MR;
Greisen, G;
... McCaul, MC; + view all
(2022)
Neuromonitoring in neonatal critical care part II: extremely premature infants and critically ill neonates.
Pediatric Research
10.1038/s41390-022-02392-2.
(In press).
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Abstract
Abstract: Neonatal intensive care has expanded from cardiorespiratory care to a holistic approach emphasizing brain health. To best understand and monitor brain function and physiology in the neonatal intensive care unit (NICU), the most commonly used tools are amplitude-integrated EEG, full multichannel continuous EEG, and near-infrared spectroscopy. Each of these modalities has unique characteristics and functions. While some of these tools have been the subject of expert consensus statements or guidelines, there is no overarching agreement on the optimal approach to neuromonitoring in the NICU. This work reviews current evidence to assist decision making for the best utilization of these neuromonitoring tools to promote neuroprotective care in extremely premature infants and in critically ill neonates. Neuromonitoring approaches in neonatal encephalopathy and neonates with possible seizures are discussed separately in the companion paper. Impact: For extremely premature infants, NIRS monitoring has a potential role in individualized brain-oriented care, and selective use of aEEG and cEEG can assist in seizure detection and prognostication.For critically ill neonates, NIRS can monitor cerebral perfusion, oxygen delivery, and extraction associated with disease processes as well as respiratory and hypodynamic management. Selective use of aEEG and cEEG is important in those with a high risk of seizures and brain injury.Continuous multimodal monitoring as well as monitoring of sleep, sleep–wake cycling, and autonomic nervous system have a promising role in neonatal neurocritical care.
| Type: | Article |
|---|---|
| Title: | Neuromonitoring in neonatal critical care part II: extremely premature infants and critically ill neonates |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1038/s41390-022-02392-2 |
| Publisher version: | https://doi.org/10.1038/s41390-022-02392-2 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Pediatrics, AMPLITUDE-INTEGRATED ELECTROENCEPHALOGRAPHY, NEAR-INFRARED SPECTROSCOPY, CEREBRAL-BLOOD-FLOW, EXTREMELY PRETERM INFANTS, PATENT DUCTUS-ARTERIOSUS, OXYGEN-SATURATION, CARBON-DIOXIDE, ELECTRICAL-ACTIVITY, PRESSURE-PASSIVITY, PROGNOSTIC VALUE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10164353 |
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