Neuromonitoring in neonatal intensive care units-an important need towards individualized neuroprotective care

Eur J Pediatr. 2024 Sep;183(9):3647-3653. doi: 10.1007/s00431-024-05642-z. Epub 2024 Jun 11.

Abstract

Neuromonitoring has been widely accepted as an important part in neonatal care. Amplitude-integrated EEG (aEEG) and near-infrared spectroscopy (NIRS) are often mentioned in this context, though being only a part of the fully array of methods and examinations that could be considered neuromonitoring. Within the broad array of medical conditions that could be encountered in a neonatal patient, it is important to be aware of the indications for neuromonitoring and especially which neuromonitoring technique to use best for the individual condition. aEEG is now a widely accepted neuromonitor in neonatology with its value in hypoxic events and seizures only rarely questioned. Other methods like NIRS still have to prove themselves in the future. The SafeBoosC-III trial showed that it still remains difficult for some of these methods to prove their value for the improvement of outcome. Bute future developments such as multimodal neuromonitoring with data integration and artificial intelligence analysis could improve the value of these methods.

Keywords: Amplitude-integrated EEG; Multimodal neuromonitoring; Near-infrared spectroscopy; Neuromonitoring; Neuroprotective care.

Publication types

  • Review

MeSH terms

  • Electroencephalography* / methods
  • Humans
  • Hypoxia-Ischemia, Brain / diagnosis
  • Hypoxia-Ischemia, Brain / prevention & control
  • Hypoxia-Ischemia, Brain / therapy
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Intensive Care, Neonatal / methods
  • Neurophysiological Monitoring / methods
  • Neuroprotection / physiology
  • Seizures / diagnosis
  • Seizures / prevention & control
  • Spectroscopy, Near-Infrared* / methods