Neurocritical care for neonates.
Neurocritical care for neonates.
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DOI：
10.1007/s12028-009-9324-7
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发表时间：
2010-06
影响因子：
3.5
通讯作者：
Ferriero, Donna M.
中科院分区：
文献类型：
--
作者：
Glass, Hannah C.;Bonifacio, Sonia L.;Peloquin, Susan;Shimotake, Thomas;Sehring, Sally;Sun, Yao;Sullivan, Joseph;Rogers, Elizabeth;Barkovich, A. James;Rowitch, David;Ferriero, Donna M.
关键词：
描述加州大学旧金山分校最近建立的新生儿神经危重护理服务(NNCS)的概念、实施、患者特征和初步结果。NNCS是为了更好地满足神经损伤风险新生儿的特殊需求而开发的。这项服务结合了专门的神经护理、专门的新生儿医疗和护理专业知识、神经监测、神经成像、神经发育护理和长期随访。NNCS在2008年7月至2009年6月期间评估的新生儿被包括在分析中。人口学数据(出生时的胎龄、性别、入院诊断和就诊原因)、结果(死亡率、住院时间)以及神经生理学和影像资源从患者图表中提取。在12个月的时间里，155名新生儿接受了评估(约占所有入院新生儿的25%)；其中51名为早产儿(妊娠36周)，104名为足月儿。大约一半是因为初级医学诊断，如早产、先天性畸形或呼吸暂停/明显生命威胁事件(ALTE)，其余因初级神经问题入院，包括围产期窒息、癫痫发作/可能的癫痫发作或先天性脑畸形。最常见的神经学诊断是缺氧缺血性脑病(38%)和癫痫(35%)。早产儿中，脑室内出血III级和脑室周围出血性脑梗塞最常见。早产儿和足月儿的死亡率都约为20%。虽然专门的神经危重护理改善了成人人口的预后，但还需要进行纵向研究，以确定专门的神经危重护理服务是否也会改善新生儿的神经发育结果。
To describe the concept, implementation, patient characteristics, and preliminary outcomes of a Neonatal Neurocritical Care Service (NNCS) recently established at the University of California, San Francisco. The NNCS was developed to better address the special needs of neonates at risk for neurological injury. The service combines dedicated neurological care, specialized neonatal medical and nursing expertise, neuromonitoring, neuroimaging, neurodevelopmental care, and long-term follow up. Newborns evaluated by the NNCS between July 2008 and June 2009 were included in the analysis. Demographic data (gestational age at birth, sex, admission diagnosis, and reason for consult), outcome (mortality, length of stay), and neurophysiology and imaging resources were extracted from patient charts. Over the 12-month period, 155 newborns were evaluated (approximately 25% of all admissions); of these, 51 were preterm (<36 weeks gestation) and 104 were term. Approximately half were admitted for primary medical diagnoses, such as preterm birth, congenital malformations or apnea/apparent life-threatening event (ALTE), with the remainder admitted for primary neurological problems, including perinatal asphyxia, seizures/possible seizures, or congenital cerebral malformation. The most common neurological diagnoses were hypoxic-ischemic encephalopathy (38%) and seizure (35%). Among preterm newborns, intra ventricular hemorrhage grade III and periventricular hemorrhagic infarction were most common. Mortality was approximately 20% in both preterm and term populations. While specialized neurocritical care has improved outcomes in adult populations, longitudinal studies are needed to determine whether specialized neurocritical care services will also result in improved neurodevelopmental outcomes for newborns.
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影响因子：
5.1
作者：
Glass, Hannah C.;Glidden, David;Jeremy, Rita J.;Barkovich, A. James;Ferriero, Donna M.;Miller, Steven P.
通讯作者：
Miller, Steven P.
影响因子：
158.5
作者：
GREGORY, GA;KITTERMAN, JA;HAMILTON, WK
通讯作者：
HAMILTON, WK
影响因子：
168.9
作者：
Gluckman, PD;Wyatt, JS;Gunn, AJ
通讯作者：
Gunn, AJ
影响因子：
3.6
作者：
Gunn, AJ;Bennet, L;Gunn, TR
通讯作者：
Gunn, TR
影响因子：
2.9
作者：
Ferriero, DM
通讯作者：
Ferriero, DM