![]() ![]() It can be useful in critically ill neonates as a trend monitor to evaluate the balance between tissue oxygen delivery and consumption, providing cerebral and somatic oximetry values, and allowing earlier identification of hemodynamic changes and brain perfusion abnormalities ( 1, 2). Near infrared spectroscopy (NIRS) is a non-invasive tool to continuously measure regional tissue oxygenation at the bedside. We speculate that routine use of these combined monitoring modalities may become the future standard for neonatal neuromonitoring.Ĭontinuous brain monitoring tools are being used more frequently in the neonatal intensive care unit (NICU) to assess brain health. These four clinical scenarios demonstrate how simultaneous neuromonitoring with aEEG and NIRS provides important clinical information. We review the use of NIRS and aEEG in neonates and describe four cases where abnormal NIRS values were immediately followed by changes in brain activity as seen on aEEG allowing the impact of a hemodynamic disturbance on the brain to be correlated with the changes in the aEEG background pattern. Several studies have described correlations between aEEG and NIRS monitoring, especially in infants with hypoxic-ischemic encephalopathy (HIE), but few describe the combined use of both monitoring techniques in a wider range of clinical scenarios. Simultaneous use of both monitoring modalities may improve the understanding of alterations in hemodynamics and risk of cerebral injury. Amplitude-integrated electroencephalography (aEEG) is a method for continuous monitoring of cerebral function at the bedside. Near infrared spectroscopy (NIRS) is useful in critically ill neonates as a trend monitor to evaluate the balance between tissue oxygen delivery and consumption, providing cerebral and somatic oximetry values, and allowing earlier identification of abnormalities in hemodynamics and cerebral perfusion. 5Neonatal Unit, Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein, São Paulo, BrazilĬontinuous brain monitoring tools are increasingly being used in the neonatal intensive care unit (NICU) to assess brain function and cerebral oxygenation in neonates at high risk for brain injury.4Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Packard Children's Hospital Stanford, Palo Alto, CA, United States.3Protecting Brains and Saving Futures Organization, São Paulo, Brazil.2Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.1Grupo Santa Joana, Division of Neonatology, São Paulo, Brazil.Chock 4, Alexandre Netto 2,3, Rafaela Fabri Rodrigues Pietrobom 2,3,5 and Krisa Page Van Meurs 4 Infants 100.Gabriel Fernando Todeschi Variane 1,2,3 *, Valerie Y. ![]() In general the transition period should be no less than 4 hours. Infants >35 weeks have no specific length of time they must stay in the NICU. These babies must come to the NICU for a period of observation to ensure normal transition. NICU Admission Criteria From from NICU Manual, Kathy Gilsbach, RN, MS The following babies must be admitted to NICU: n n n n Babies less than 351/7 weeks as documented on the yellow 'Birth Record' and less than 2000 gms. ![]()
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