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The development of neonatal neurointensive care
Pediatric Research ( IF 3.6 ) Pub Date : 2019-12-18 , DOI: 10.1038/s41390-019-0729-5
Topun Austin 1
Affiliation  

Brain injury remains one of the major unsolved problems in neonatal care, with survivors at high risk of lifelong neurodisability. It is unlikely that a single intervention can ameliorate neonatal brain injury, given the complex interaction between pathological processes, developmental trajectory, genetic susceptibility, and environmental influences. However, a coordinated, interdisciplinary approach to understand the root cause enables early detection, and diagnosis with enhanced clinical care offering the best chance of improving outcomes and facilitate new lines of neuroprotective treatments. Adult neurointensive care has existed as a speciality in its own right for over 20 years; however, it is only recently that large prospective studies have demonstrated the benefit of this model of care. The ‘Neuro-intensive Care Nursery’ model originated at the University of California San Francisco in 2008, and since then a growing number of units worldwide have adopted this approach. As well as providing consistent coordinated care for infants from a multidisciplinary team, it provides opportunities for specialist education and training in neonatal neurology, neuromonitoring, neuroimaging and nursing. This review outlines the origins of brain-oriented care of the neonate and the development of the Neuro-NICU (neonatal intensive care unit) and discusses some of the challenges and opportunities in expanding this model of care.

中文翻译:

新生儿神经重症监护的发展

脑损伤仍然是新生儿护理中未解决的主要问题之一,幸存者面临终生神经残疾的高风险。鉴于病理过程、发育轨迹、遗传易感性和环境影响之间的复杂相互作用,单一干预不太可能改善新生儿脑损伤。然而,通过协调、跨学科的方法来了解根本原因,可以通过增强的临床护理进行早期检测和诊断,从而提供改善结果和促进新的神经保护治疗线的最佳机会。成人神经重症监护作为一项专科已经存在了 20 多年。然而,直到最近,大型前瞻性研究才证明了这种护理模式的好处。“神经重症监护托儿所”模式于 2008 年起源于加州大学旧金山分校,从那时起,全球越来越多的单位采用了这种方法。除了从多学科团队为婴儿提供一致的协调护理外,它还为新生儿神经病学、神经监测、神经影像学和护理方面的专业教育和培训提供机会。本综述概述了以脑为导向的新生儿护理的起源和 Neuro-NICU(新生儿重症监护病房)的发展,并讨论了扩展这种护理模式的一些挑战和机遇。它为新生儿神经病学、神经监测、神经影像学和护理方面的专业教育和培训提供机会。本综述概述了以脑为导向的新生儿护理的起源和 Neuro-NICU(新生儿重症监护病房)的发展,并讨论了扩展这种护理模式的一些挑战和机遇。它为新生儿神经病学、神经监测、神经影像学和护理方面的专业教育和培训提供机会。本综述概述了以脑为导向的新生儿护理的起源和 Neuro-NICU(新生儿重症监护病房)的发展,并讨论了扩展这种护理模式的一些挑战和机遇。
更新日期:2019-12-18
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