Designing the landscape for technological development in neonatal neurocritical care

Abstract

ObjectivesTo identify current ‘gaps’ in clinical practice or therapeutic knowledge of the care of neonatal neurointensive care patients and to determine the impact healthcare technologies can have on improving outcomes.DesignThe Cambridge Institute for Manufacturing’s (IfM) roadmapping methodology.SettingCambridge, UK.Participants16 delegates were selected through professional networks. They provided coverage of academia and clinical skills, as well as expertise in neonatology, engineering and technology development.Main outcome measuresA ‘strategic landscape’ has been developed with ‘landmarks’ identified as ‘trends or drivers’, ‘patient pathway experience and unmet needs’ and ‘enabling project or resources’. Priorities were voted on by delegates.Results26 strategic ‘landmarks’ were identified, and of these 8 were considered ‘trends or drivers’, 8 ‘patient pathway experience and unmet needs’ and 10 as ‘enabling project or resources’. Of these, five priorities for the future of neonatal neurocritical care were identified by a voting process: real-time video monitoring for parents; individualised management of preterm infants in neonatal neurocritical care based on real-time multimodal monitoring; continuous electroencephalogram monitoring for early seizure diagnosis; neuroprotection: understanding basic mechanisms; and sleep measurement.ConclusionsThrough the use of the IfM methodology, a list of priorities has been developed for future work into improving the experience and possible outcomes of newborn infants with brain injuries and their families. While not an exhaustive list, it provides the beginning for a national conversation on the topic.

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

“…While there is strong evidence that adults with acute neurological conditions benefit from a specialized neurocritical care, the impact of such care in the neonatal population is less clear [ 8 , 46 ]. However, emerging evidence suggests its potentially positive impact on neurodevelopmental outcome [ 24 , 31 , 46 – 48 ]. Glass et al demonstrated that the rate of epilepsy after acute symptomatic neonatal seizures was lower in a cohort of newborns managed by a neonatal neurocritical care service [ 10 ].…”

“…The first step in the development of our NNCUs was the encouragement of the parent-infant bonding time [ 24 ]. Our ultimate goal was to have neuro-NICU available to the parents for 24 hours, but as the first step, we aimed to arrange for a comfortable overnight stay for the mother.…”