A neonatal neuroNICU collaborative approach to neuromonitoring of posthemorrhagic ventricular dilation in preterm infants

Whittemore, Brett A.; Swift, Dale M.; Thomas, Jeffrey L.; Chalak, Lina F.

doi:10.1038/s41390-021-01406-9

Cited by 8 publications

(3 citation statements)

References 101 publications

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“…In many level IV NICUs, neurocritical care programs have grown to include collaborations between neonatologist, neurologist, and neurosurgeons. 11 While these collaborations exist, the absence of consensus-based guidelines leads to practice differences within and between centers.…”

Section: Discussionmentioning

confidence: 99%

Survey of Quaternary Neonatal Management of Posthemorrhagic Hydrocephalus

et al. 2021

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Objective This study aimed to determine clinical care practices for infants at risk for posthemorrhagic hydrocephalus (PHH) across level IV neonatal intensive care units (NICUs). Study Design Cross-sectional survey that addressed center-specific surveillance, neurosurgical intervention, and follow-up practices within the Children's Hospitals Neonatal Consortium. Results We had a 59% (20/34 sites) response rate, with 10 sites having at least two participants. Respondents included neonatologists (53%) and neurosurgeons (35%). Most participants stated having a standard guideline for PHH (79%). Despite this, 42% of respondents perceive inconsistencies in management. Eight same-center pairs of neonatologists and neurosurgeons were used to determine response agreement. Half of these pairs disagreed on nearly all aspects of care. The greatest agreement pertained to a willingness to adopt a consensus-based protocol. Conclusion Practice variation in the management of infants at risk of PHH in level IV NICUs exists despite the perception that a common practice is available and used. Key Points

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Section: Discussionmentioning

confidence: 99%

Survey of Quaternary Neonatal Management of Posthemorrhagic Hydrocephalus

et al. 2021

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“…This review can improve the understanding of IVH in preterm infants among neurosurgeons, neonatologists and obstetricians in the field. Moreover, with recent advances in noninvasive monitoring [ 6 ], this study is expected to lead to future evidence for individualized cerebral and systemic hemodynamic monitoring in preterm infants.…”

Section: Pathogenesis and Prevention Of Ivh In Preterm Infants [ ...mentioning

confidence: 99%

Editor’s Pick in May 2023

Kim¹,

Kim²

2023

J Korean Neurosurg Soc

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“…Near-infrared spectroscopy (NIRS) measures cerebral oxygen saturation (SO 2 ) and is a widely available means of physiological monitoring that can be employed safely and conveniently at the bedside. Although SO 2 is easy to measure, it does not always offer a comprehensive understanding of infant brain pathophysiology and disease progression [20], and has limited diagnostic value for hydrocephalus [21].…”

Section: Introductionmentioning

confidence: 99%

Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC

et al. 2022

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Infant hydrocephalus poses a severe global health burden; 80% of cases occur in the developing world where patients have limited access to neurosurgical care. Surgical treatment combining endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC), first practiced at CURE Children’s Hospital of Uganda (CCHU), is as effective as standard ventriculoperitoneal shunt (VPS) placement while requiring fewer resources and less post-operative care. Although treatment focuses on controlling ventricle size, this has little association with treatment failure or long-term outcome. This study aims to monitor the progression of hydrocephalus and treatment response, and investigate the association between cerebral physiology, brain growth, and neurodevelopmental outcomes following surgery. We will enroll 300 infants admitted to CCHU for treatment. All patients will receive pre/post-operative measurements of cerebral tissue oxygenation (SO2), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen consumption (CMRO2) using frequency-domain near-infrared combined with diffuse correlation spectroscopies (FDNIRS-DCS). Infants will also receive brain imaging, to monitor tissue/ventricle volume, and neurodevelopmental assessments until two years of age. This study will provide a foundation for implementing cerebral physiological monitoring to establish evidence-based guidelines for hydrocephalus treatment. This paper outlines the protocol, clinical workflow, data management, and analysis plan of this international, multi-center trial.

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A neonatal neuroNICU collaborative approach to neuromonitoring of posthemorrhagic ventricular dilation in preterm infants

Cited by 8 publications

References 101 publications

Survey of Quaternary Neonatal Management of Posthemorrhagic Hydrocephalus

Survey of Quaternary Neonatal Management of Posthemorrhagic Hydrocephalus

Editor’s Pick in May 2023

Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC

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