Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Pediatr Res. 2024 Sep;96(4):868-874. doi: 10.1038/s41390-019-0729-5. Epub 2019 Dec 18.
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.
脑损伤仍然是新生儿护理中尚未解决的主要问题之一，幸存者存在终身神经残疾的高风险。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，单一干预措施不太可能改善新生儿脑损伤。然而，通过协调的跨学科方法了解根本原因，可以实现早期检测和诊断，提供更好的临床护理，从而提高治疗效果并为新的神经保护治疗方法提供机会。成人神经重症监护作为一个独立的专业已经存在了 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益处。“神经重症监护病房”模式于 2008 年起源于加利福尼亚大学旧金山分校，此后，全球越来越多的单位采用了这种方法。除了为多学科团队的婴儿提供一致的协调护理外，它还为新生儿神经学、神经监测、神经影像学和护理方面的专业教育和培训提供了机会。这篇综述概述了新生儿脑定向护理的起源以及神经新生儿重症监护病房（NICU）的发展，并讨论了扩展这种护理模式的一些挑战和机遇。
