scholarly journals P.130 Canadian physician attitudes towards long term EEG monitoring in the neonatal intensive care unit

2018 ◽  
Vol 45 (s2) ◽  
pp. S50-S50
Author(s):  
SG Buttle ◽  
E Sell ◽  
B Lemyre ◽  
D Pohl
Keyword(s):  
Neonatal Intensive Care ◽  
Physician Attitudes ◽  
Eeg Monitoring ◽  
Educational Materials ◽  
Education Session ◽  
Provider Attitudes ◽  
Canadian Physician ◽  
Critically Ill Neonates ◽  
Current Monitoring

Background: Long-term EEG monitoring (LTEM), including amplitude-integrated (aEEG) or conventional EEG (cEEG), is increasingly being used in critically ill neonates. Despite an abundance of studies regarding the clinical utility of LTEM, much is unknown regarding provider attitudes toward this tool. We aimed to evaluate neurologist and neonatologist opinions regarding LTEM in the NICU and describe current Canadian practices. Methods: A 15-item questionnaire was developed with input from neonatologists and pediatric neurologists at two Canadian centres. The questionnaire was piloted at our hospital and subsequently distributed to Canadian neonatologists and pediatric neurologists. Results: All 16 local respondents use LTEM in the NICU. Neonatologists were more likely to combine aEEG and cEEG, and monitor for longer durations than pediatric neurologists. However, most pediatric neurologists would like to monitor more (71%), compared to neonatologists who were more likely to say that current monitoring practices are sufficient. High rates of neonatologists (88%) and neurologists (85%) are interested in attending an education session on LTEM. Conclusions: Preliminary data suggests neonatologists and pediatric neurologists differ in their approach to LTEM. Results from our national questionnaire will be analyzed shortly, and may inform the development of educational materials as well as future studies that involve multi-centre efforts.

scholarly journals Continuous Electroencephalography Monitoring for Critically Ill Neonates: A Canadian Perspective

2019 ◽  
Vol 46 (04) ◽  
pp. 394-402 ◽  
Author(s):  
Sarah Grace Buttle ◽  
Erick Sell ◽  
Richard Webster ◽  
Melanie Varin ◽  
Brigitte Lemyre ◽  
...  
Keyword(s):  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Eeg Monitoring ◽  
Neurodevelopmental Outcomes ◽  
Provider Attitudes ◽  
Continuous Eeg ◽  
Significant Difference ◽  
Continuous Eeg Monitoring ◽  
Critically Ill Neonates ◽  
Detection And Diagnosis

ABSTRACT:Background: Continuous EEG monitoring, in the form of amplitude-integrated (aEEG) or conventional EEG (cEEG), is used in the neonatal intensive care unit (NICU) to detect subclinical central nervous system pathologies, inform management, and prognosticate neurodevelopmental outcomes. To learn more about provider attitudes and current practices in Canada, we evaluated neurologist and neonatologist opinions regarding NICU EEG monitoring. Methods: A 15-item electronic questionnaire was distributed to 114 pediatric neurologists and 176 neonatologists working across 25 sites. Results: The survey was completed by 87 of 290 physicians. Continuous EEG monitoring is utilized by 97% of pediatric neurologists and 92% of neonatologists. Neurologists and neonatologists differ in their EEG monitoring preferences. For seizure detection and diagnosis of encephalopathy, significantly more neonatologists favor aEEG alone or in combination with cEEG, whereas most neurologists prefer cEEG (p = 0.047, 0.001). There is a significant difference in the perceived gaps in monitoring patients with cEEG between neonatologists (13% would monitor more) and neurologists (41% would monitor more) (p = 0.007). Half of all respondents (53%) reported that they would be interested in attending an education session on neonatal EEG monitoring. Conclusions: Canadian neurologists and neonatologists do not agree on the best monitoring approach for critically ill neonates. Furthermore, neonatologists perceive a smaller cEEG monitoring gap as compared with neurologists. However, many participants from both specialties would like to increase long-term EEG monitoring in the NICU setting. Facilitating access to EEG monitoring and enhancing education may help to address these needs.

scholarly journals From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Raffaele Falsaperla ◽  
Laura Mauceri ◽  
Milena Motta ◽  
Ettore Piro ◽  
Gabriella D’Angelo ◽  
...  
Keyword(s):  
At Risk ◽  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Neurocritical Care ◽  
Brain Protection ◽  
Model Of Care ◽  
Newborn Brain ◽  
Critically Ill Neonates

Background. Neonatal brain injury (NBI) can lead to a significant neurological disability or even death. After decades of intense efforts to improve neonatal intensive care and survival of critically ill newborns, the focus today is an improved long-term neurological outcome through brain-focused care. The goal of neuroprotection in the neonatal intensive care unit (NICU) is the prevention of new or worsening NBI in premature and term newborns. As a result, the neonatal neurocritical care unit (NNCU) has been emerging as a model of care to decrease NBI and improve the long-term neurodevelopment in critically ill neonates. Purpose. Neurocritical care (NCC) Sicilian project includes three academic sites with NICU in Sicily (Catania, Messina, and Palermo), and its primary goal is to develop neurocritical neonatal care unit (NNCU). Methods. In 2018, the three NICUs created a dedicated space for neonates with primary neurological diagnosis or at risk for neurological injuries—NNCU. Admission criteria for eligible patients and treatment protocols were created. Contact with parents, environmental protection, basic monitoring, brain monitoring, pharmacological therapy, and organization of the staff were protocolized. Results. Evaluation of the efforts to establish NNCU within existing NICU, current protocols, and encountered problems are shown. Implications for Practice. Our outcome confirmed the need for dedicated NNCU for neuroprotection of critically ill neonates at risk for a neurological injury. Although the literature on neonatal neurocritical care is still scarce, we see the value of such targeted approach to newborn brain protection and therefore we will continue developing our NNCU, even though there have been problems encountered. The project of building NNCU will continue to be closely monitored. Conclusions. The development of our neonatal neurocritical model of care is far from being completed. Although it is currently limited to the Sicilian area only, the goal of this paper is to share the development of this multicenter interdisciplinary project focused on a newborn brain protection. After evaluating our outcome, we strongly believe that a combined expertise in neonatal neurology and neonatal critical care can lead to an improved neurodevelopmental outcome for critically ill neonates, from the extremely preterm to those with brain injuries.

Improving Feeding Outcomes in the NICU: Moving From Volume-Driven to Infant-Driven Feeding

2010 ◽  
Vol 19 (3) ◽  
pp. 68-74 ◽  
Author(s):  
Catherine S. Shaker
Keyword(s):  
Intensive Care Unit ◽  
Dynamic Systems ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Dynamic Systems Theory ◽  
Feeding Problems ◽  
Care Giving ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Current research on feeding outcomes after discharge from the neonatal intensive care unit (NICU) suggests a need to critically look at the early underpinnings of persistent feeding problems in extremely preterm infants. Concepts of dynamic systems theory and sensitive care-giving are used to describe the specialized needs of this fragile population related to the emergence of safe and successful feeding and swallowing. Focusing on the infant as a co-regulatory partner and embracing a framework of an infant-driven, versus volume-driven, feeding approach are highlighted as best supporting the preterm infant's developmental strivings and long-term well-being.

Point of Care Neurosonogram in Neonates - Utility and Prognostic Value

2019 ◽  
Vol 2 ◽  
pp. 1
Author(s):  
Bhushita Lakhkar ◽  
M. M. Patil ◽  
Bhavana Lakhkar ◽  
Bhushan Lakhkar
Keyword(s):  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Color Doppler ◽  
Periventricular Leukomalacia ◽  
Birth Asphyxia ◽  
Common Finding ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Study

Objective The study aimed to utilize the neurosonographic findings in neonates in early diagnosis, prediction of their long-term outcome, parental counseling, and early intervention. Methods The study was carried out in neonatal intensive care unit (NICU) of Shri BM Patil Medical College and Hospital. All preterms and term babies with neurological clinical findings were included in the study. Neurosonogram was done within first 7 days in preterms and when indicated in terms. Philips HD11XE ultrasound and color Doppler unit were used with a small footprint probe. Color Doppler images for vessels were performed for screening of vascular changes. Results A total of 215 babies were included, of which 80 (32%) were term and the rest were preterm. Mean weight of term babies was 2.8 kg and that of preterm was 1.2 kg.Among term babies, 78% showed ultrasound abnormality, and among preterm, 42%showed abnormalities. Among term babies, 60% and, among preterms, 30% had birth asphyxia. Periventricular leukomalacia was the most common and earliest finding followed by thalamic hyperechogenicity and intracranial hemorrhage. Intraventricular hemorrhage was more common in preterm babies. Other common finding in NICU was meningitis which was more common in pretrms. Among congenital anomalies, corpus callosal agenesis was more common. Conclusions Point of care ultrasonography along with Doppler study is very useful and safe to use in NICUs. It helps in diagnosis, patient management as well as prediction of many short- and long-term outcomes.

Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage
Keyword(s):  
Family Relationships ◽  
Mentally Ill ◽  
Expressed Emotion ◽  
Realistic Model ◽  
Education Session ◽  
Term Care ◽  
Interactive Education ◽  
Severely Mentally Ill ◽  
Group Facilitators

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

Routine EEG and Temporal Lobe Epilepsy: Relation to Long-Term EEG Monitoring, Quantitative MRI, and Operative Outcome

Epilepsia ◽  
1996 ◽  
Vol 37 (7) ◽  
pp. 651-656 ◽  
Author(s):  
Gregory D. Cascino ◽  
Max R. Trenerry ◽  
Elson L. So ◽  
Frank W. Sharbrough ◽  
Cheolsu Shin ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Quantitative Mri ◽  
Eeg Monitoring ◽  
Operative Outcome

Technical implementation and clinical findings/results of monitoring oxygen saturation in patients referred for long term EEG monitoring

1996 ◽  
Vol 99 (5) ◽  
pp. 432-439 ◽  
Author(s):  
J.R. Ives ◽  
N.R. Mainwaring ◽  
K.B. Krishnamurthy ◽  
A.S. Blum ◽  
F.W. Drislane ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Clinical Findings ◽  
Eeg Monitoring

Very Low Birth Weight Outcomes

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 357-357
Author(s):  
HELEN HARRISON
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Low Birth Weight Infants ◽  
Randomized Controlled Clinical Trials ◽  
Weight Outcomes ◽  
Term Evaluation

To the Editor.— The authors of the National Institute of Child Health and Human Development report on neonatal care1 found "important" variations among neonatal intensive care units in philosophies of treatment, methods of treatment, and short-term outcomes. In a recent meta-analysis of follow-up studies,2 researchers document a similarly haphazard approach to the long-term evaluation of very low birth weight survivors. Until randomized controlled clinical trials validate the safety and efficacy of neonatal therapies, and until long-term outcomes are assessed accurately, the treatment of very low birth weight infants should be declared experimental.

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