Abstract
Objective Many critically ill neonates have an existing brain injury or are at risk of neurologic
injury. We developed a “NeuroNICU” (neurologic neonatal intensive care unit) to better
provide neurologically focused intensive care.
Study Design 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.
Results 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.
Conclusion 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.
Keywords
neuroNICU - neuromonitoring - neurocritical care - seizure - cEEG - aEEG
