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December 12, 2019

Recent Technology Developments in Neonatal Care



Over the last decade or so, the standard of preterm infant care has improved significantly. However, prematurity is still considered to be a serious health issue that accounts for almost 50% of perinatal mortality. The advent of modern technology has resulted in significant progress in neonatal care. The preterm infant survival rate has increased since the development of infant incubators. The technology for neonatology has experienced continuous improvement over the last few years, and now, double-walled servo-controlled incubators are available for preterm infants. Mechanical ventilators with built-in algorithms are also available these days.



According to Americord, one of America’s leading cord blood banking solutions, the use of modern technology along with computer intelligence can be of immense help to neonatal caregivers looking after preterm infants.  Preterm infants are extremely fragile and the neonatal caregivers are required to operate under narrow normal and safe value ranges. With built-in algorithms, modern technical devices can help caregivers adhere to these ranges and minimize the duration and probability of injurious moments.  Some of the recent technological innovations designed to improve neonatal care are discussed below.

  • Clinical evidence suggests that preterm infants are most vulnerable to injuries immediately after their birth. Lung and cerebral injury because of improper ventilation is extremely common. Immediate cord clamping is required for providing necessary respiratory support. This, however, may cause hemodynamic instability.  Efforts have been initiated now to stabilize the preterm infants close to the mother, while the cords are still intact. Purpose-built resuscitation tables with platforms have been developed. It is possible to place these tables very close to the canal so that the caregivers can provide complete care while the cord is still intact.  Many more similar projects are still in the development phase, and there is no doubt that preterm infant stabilization, while the cord remains intact, can surely make the transition stable and gentle.
     
  • Several parameters and data points are collected and managed during admission in the NICU. This data includes sensor readings, vital physiological parameters, results of tests, data from devices such as infusion pumps and ventilators, and interventions and observations of the caregivers. This enormous volume of data can be utilized for predictive monitoring in a NICU. Analysis of physiological data can help detect illness at an early stage and identify infants at high risk.
     
  • One of the most recurrent and common problems in preterm infants is apnea of prematurity combined with bradycardia and/or hypoxia. Frequent apneic spells are responsible for neurodevelopmental irregularities and serious brain damage.  The response time of the caregivers plays a significant role in the duration of the concomitant hypoxia the apnea.  Factors such as alarm fatigue and heavy workload impact this response time negatively.  This issue can be addressed effectively by the automatic application of tactile stimulation. Studies have already established that the duration and occurrence of apneas in preterm infants can be decreased by automatic vibrotactile stimulation. 
     
  • Supplemental oxygen is generally provided to preterm infants during the admission in the NICU.  However, the therapeutic range of supplemental oxygen therapy is extremely narrow for preterm infants, resulting in their exposure to hypoxemia or hypoxemia.  Nurses generally solve this problem by manual titration of oxygen for maintaining the target SpO2 ranges. However, this manual process can be extremely challenging for nurses. The latest technology allows automated regulation of FiO2, and this innovation has been increasingly used all over the world in neonatal intensive care. Many different devices for automated oxygen control are now available and selling successfully in the market.
     
  • One of the latest innovations in neonatal medicine is the introduction of the artificial placenta into clinical practice. An artificial placenta’s aim is to create an environment that allows continuous development of the fetus just as it would in the maternal uterus, without the common stress factors associated with preterm birth.


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