Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Biomed J. 2020 Jun;43(3):259-267. doi: 10.1016/j.bj.2020.03.007. Epub 2020 Apr 22.
Neurocritical care is an approach of comprehensive care through multidisciplinary coordination and implementation of neuroprotective strategies to reduce the risk of neurologic injury among critically ill patients. Premature infants are at a special risk of sustaining brain injury and having adverse neurodevelopmental outcome. The pathogenesis of "encephalopathy of prematurity" is tightly linked to hemodynamic instability during postnatal transition, immaturity of the cerebral vascular bed and nervous system, and the commonly encountered inflammation in an intensive care setting. Clinical assessment aided by renewed monitoring techniques, together with therapies supported by best available evidence may provide opportunities to salvage these vulnerable brains. Indeed, to promote optimal brain development and to ensure neurodevelopmental intact survival is of imperial priority in the modern care of preterm infants.
神经危重症医学是一种通过多学科协调和实施神经保护策略来降低危重症患者神经损伤风险的综合治疗方法。早产儿特别容易发生脑损伤和不良神经发育结局。“早产儿脑病”的发病机制与出生后过渡期间的血流动力学不稳定、脑血管和神经系统不成熟以及重症监护环境中常见的炎症密切相关。借助更新的监测技术进行临床评估,并结合最佳现有证据支持的治疗方法,可能为挽救这些脆弱的大脑提供机会。实际上,促进早产儿最佳脑发育并确保神经发育完整生存是现代早产儿护理的首要任务。