At this time, ACH supplies whole-body cooling in its neonatal neurocritical care program, which incorporates the neonatology intensive care unit (NICU) and neurology. This program supplies high-level, specialised care to new child sufferers.
Therapeutic hypothermia, or whole-body cooling, is the scientific remedy of deliberately reducing an toddler’s physique temperature at a managed tempo. The physique is cooled for a particular interval to cut back mind injury after an damage brought on by a scarcity of oxygen or blood circulate to the newborn’s mind. The expertise is positioned inside six hours after a child’s start and cools them for 72 hours.
The group that leads the neurocritical care program contains neonatal nurses with specialised experience, neonatal neurologists, pediatric neuroradiologists, pediatric neurosurgeons and neonatologists.
ACH was a part of the unique medical trials that studied cooling for hypoxic-ischemic encephalopathy (HIE). This damage interrupts blood circulate and oxygen to the mind when a child is delivered. Cooling continues to be the one remedy for one of these mind damage. The group carried out greater than 150 new neurology consults in 2023, and that quantity is on tempo to develop in 2025. In 2023, 37 infants acquired cooling for HIE by the neonatal neurocritical group.
“This devoted, very specialised group distinguishes us from different NICUs in Arkansas, together with being the one Degree IV NICU within the state. This group permits us to offer comparable care alongside different prime kids’s hospitals nationwide,” mentioned Ashley S. Ross, M.D., neonatologist and chief of neonatology at Arkansas Kids’s and professor of pediatrics on the College of Arkansas for Medical Sciences (UAMS). “Sufferers referred to ACH, even after receiving remedy at different NICUs, are evaluated by the neonatal neurologist, and their neuroimaging is reviewed or carried out by pediatric specialists.”
Revolutionary Remedies
Neurocritical care program specialists deal with a number of situations, together with:
- Mind malformations
- Congenital neuromuscular problems
- Genetic and metabolic problems
- Intraventricular hemorrhage and different types of intracranial hemorrhage
- HIE
- Hypothermia
- Neonatal encephalopathy
- Neonatal stroke
- Seizures
“We now have moved from head cooling to whole-body cooling as a result of it’s a lot simpler. It requires specialised data and ability set from our nurses,” Dr. Ross mentioned. “The NICU makes use of the Worldwide Biomedical TecoTHERM Neo Toddler Cooling System for this. Cooling can also be executed throughout transport,” through Arkansas Kids’s Angel One Affected person Transport System.
This system additionally affords fetal MRIs and prenatal consultations for neurologic problems.
“Seeking to the longer term, we’re exploring methods to broaden that means to offer superior neuroimaging,” Dr. Ross mentioned.
Households may also take part in neonatal neurology analysis led by pediatric neurology and neonatology.
“We’re the one complete therapeutic hypothermia program within the state that provides steady Video Electroencephalogram (VEEG) monitoring, which helps diagnose mind problems like epilepsy, learn by an in-house pediatric epileptologist, neonatal neurologist session, neonatal particular MRI capabilities and pediatric neuroradiology,” mentioned Sarah Cobb, M.D., a pediatric neurologist at ACH and assistant professor within the division of pediatrics in neurology at UAMS. “We’re additionally one of many few websites across the nation enrolling infants in a research for a novel HIE drug.”
Saving Lives
Using cooling expertise has improved the survival fee of newborns.
“The power to broaden cooling whereas being transferred to our doorsteps from the referring hospital has an impression. We all know that the sooner you’ll be able to cool a affected person earlier than six hours after start, the higher the prospect of a optimistic consequence,” Dr. Ross mentioned.
Virginia Erin Willis, M.D., pediatric neurologist and chief of neurology at Arkansas Kids’s and affiliate professor of pediatrics at UAMS, mentioned they’ve additionally seen success in enhancing the well being of pediatric sufferers with stroke and traumatic mind accidents.
“We can provide tissue plasminogen activator (TPA) and do intravascular choices for a pediatric stroke. When kids should not shifting on one facet, now we have a protocol; we all know precisely what to do, so once they go dwelling, they’ll nonetheless reside a full life,” Dr. Willis mentioned. “Sufferers with traumatic mind accidents usually have frequent seizures or mind bleeds. This group works collectively and is aware of what to do rapidly. It then extends to working with the remainder of the neuroscience and rehabilitation groups to make sure these sufferers have a plan to get them again to highschool and functioning one of the best ways they’ll.”
Dr. Willis mentioned that due to this system’s success, it’s going to broaden to different hospital specialties.
“We at the moment are extending to the pediatric intensive care unit (PICU) and hopefully ultimately to the cardiovascular intensive care unit (CVICU). Along with Dr. Cobb’s work within the NICU, one other epileptologist will be part of the group. We’ll even have neurologist Adrianne Parkey, M.D., transfer into the PICU,” Dr. Willis mentioned. “We’re recruiting for a stroke neurologist who will assist in the CVICU for these little ones who’ve strokes. We’re very pleased with our success up to now via devoted care, taking part in conferences and new scientific trials.”
This text was written by the Arkansas Kids’s content material group and medically reviewed by Dr. Ashley S. Ross and Dr. Virginia Erin Willis.
