Neuro Neonatal Intensive Care Unit

In April 2013, Stanford launched its Neuro Neonatal Intensive Care Unit (Neuro-NICU), which is housed within the Level III Intensive Care Nursery at Lucile Packard Children’s Hospital Stanford.

Many critically ill neonates have an existing brain injury or are at risk of neurologic injury. Van Meurs et al., developed a “NeuroNICU” (neurologic neonatal intensive care unit) to better provide neurologically focused intensive care.

Demographic and clinical variables, services delivered, and patient outcomes were recorded in a prospective database for all neonates admitted to the NeuroNICU between April 23, 2013, and June 25, 2015.

In total, 546 neonates were admitted to the NeuroNICU representing 32% of all NICU admissions. The most common admission diagnoses were congenital heart disease (30%), extreme prematurity (18%), seizures (10%), and hypoxic-ischemic encephalopathy (9%). Neuromonitoring was common, with near-infrared spectroscopy used in 69%, amplitude-integrated electroencephalography (EEG) in 45%, and continuous video EEG in 35%. Overall, 43% received neurology or neurosurgery consultation. Death prior to hospital discharge occurred in 11%. Among survivors, 87% were referred for developmental follow-up, and among those with a primary neurologic diagnosis 57% were referred for neurology or neurosurgical follow-up.

The NeuroNICU-admitted newborns with or at risk of brain injury comprise a high percentage of NICU volume; 38% had primary neurologic diagnoses, whereas 62% had medical diagnoses. We found many opportunities to provide brain focused intensive care, impacting a substantial proportion of newborns in our NICU ¹⁾.