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In 2013, Stanford Medicine Children’s Health created one of the nation’s first Neuro-Neonatal Intensive Care Unit (Neuro-NICU), where at-risk term and preterm newborns are cared for by a specially trained team of pediatric neurologists, neurophysiologists, neonatologists, development experts, critical care nurses, psychologists, neuroradiologists, occupational therapists and physical therapists.
Many babies who are born premature or who have critical illnesses are at increased risk for neurodevelopmental problems. Not long ago, there was little physicians could do to help protect them. Recent advances in monitoring and assessment tools now allow Neuro-NICU clinicians to track the physiology and function of newborn brains, and with the introduction of therapeutic hypothermia and other techniques for minimizing damage to young brains, we are now able to help.
The Neuro-NICU employs advanced monitoring technologies such as near-infrared spectroscopy (NIRS), which allows assessment of a brain’s oxygen level through a tiny sensor placed on the forehead, and amplitude-integrated electroencephalography (aEEG), an easy-to-apply EEG that allows physicians to monitor brain activity for seizures and other troubles.
The Neuro-NICU team works not only to prevent brain injury but also to promote brain development. For example, clinicians use induced therapeutic hypothermia, a treatment shown to significantly reduce the danger of brain damage for patients with hypoxic ischemic encephalopathy (HIE), but they also cultivate a nurturing healing environment that minimizes pain for patients and reduces stress for newborns and families. Providers give babies positive sensory experiences and engage parental involvement through kangaroo care, positive touch, positioning and massage therapy.
As eager as parents are to take the step toward normalcy, the transfer home from the NICU could be overwhelming. Neuro-NICU providers, including the high-risk infant development team, neurologists and other specialists, help ease this transition and provide continuing care after discharge.