Clinician-to-Clinician Update Clinician-to-Clinician Update

Optimizing Care for Critically Ill Newborns

June 2015 - Neonatology

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Survival rates of newborns in neonatal intensive care units (NICUs) have been studied extensively over the past decade. Although survival rates vary with gestational age, birth weight, and underlying disease, studies have demonstrated that delivery and NICU care at a high-volume hospital reduce the risk of infant mortality over that found at a low- or medium-volume hospital.1 This is particularly the case for very low-birth-weight infants, where the rate of survival is 3 to 5 times greater in a high-volume center than it is in a center with a lower volume of patients.2,3 These data support the practice of concentrating high-risk deliveries in hospitals with NICUs that have both a high level of care and a high volume of patients.

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The availability of advanced clinical services and coordinated care are other factors in improving outcomes for infants needing intensive care. Neonatology at University of Minnesota’s Masonic Children’s Hospital is ranked among the top programs in the nation by U.S. News & World Report and is the highest ranked program in Minnesota. The hospital’s high-volume, level 4 NICU has been recognized for exceptional care in extracorporeal membrane oxygenation (ECMO), a lifesaving support for very sick infants. The NICU is among only 2 in the state of Minnesota and the only one in the Minneapolis-St. Paul metro area to offer the March of Dimes NICU Family Support program. The program provides information and guidance to families of premature babies and other critically ill newborns being cared for in a NICU.

Through its follow-up clinics, the NICU, in close coordination with the University of Minnesota’s Center for Neurobehavioral Development, provides infants with continuing nutritional and neurodevelopmental care for years after their discharge from the hospital. University of Minnesota Health facilities also provide continuity of care across coordinated services, offering neuropsychology, occupational therapy, physical therapy, social work, and nutrition support for these infants and their families. The multidisciplinary team of specialists in the NICU follow-up clinics see former NICU patients for neurodevelopmental assessments at 4 months, 1 year, 2 years, and at 4 to 5 years of age, scheduling additional visits as needed. These clinics also provide education and support to families whose children may need additional services.

In the Maternal-Fetal Medicine Center, immediately adjacent to the children’s hospital and NICU, caregivers offer a comprehensive range of obstetrical care and fetal diagnosis and treatment services, including management of complex conditions requiring coordinated care through the Fetal Diagnosis and Treatment Center. If admission to the NICU is anticipated early on, neonatologists and other pediatric medical and surgical specialists will meet with obstetric patients before the infant’s birth to review plans for their baby’s care and to orient them to the NICU, providing information on the makeup of the care team and the resources and support that will be provided. Providers will also offer patients and families tours of the University of Minnesota Masonic Children’s Hospital.

References

1. Phibbs CS, Bronstein JM, Buxton E, et al. The effects of patient volume and level of care at the hospital of birth on neonatal mortality. JAMA. 1996;276:1054-1059.

2. Wehby GL, Ullrich F, Xie Y. Very low birth weight hospital volume and mortality: an instrumental variables approach. Med Care. 2012;50:714-721.

3. Phibbs CS, Baker LC, Caughey AB, et al. Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants. N Engl J Med. 2007;356:2165-2175.

When to Refer

The level IV Neonatal ICU at University of Minnesota Masonic Children’s Hospital manages neonates and infants with any medical or surgical issue, including:

  • Prematurity and low birth weight
  • Bacterial and viral infections
  • Cancer and tumors
  • Cardiac abnormalities
  • Congenital anomalies
  • Ear, nose, and throat conditions
  • Gastrointestinal disorders
  • Intrauterine growth retardation
  • Metabolic/endocrine conditions
  • Neurological conditions
  • Pulmonary disorders
  • Renal conditions
  • Skin disorders

24/7 Neonatal Transport or Physician Consultation Line: 612-273-7032

NICU follow-up care appointments: 612-365-6777

Our location is:
Neonatal Intensive Care Unit
University of Minnesota Masonic Children’s Hospital
2450 Riverside Ave., Minneapolis, MN 55454

Collaborative Care

The NICU at University of Minnesota Masonic Children’s Hospital provides exceptional, leading-edge care for the smallest newborns and the most complex cases. The multidisciplinary University of Minnesota Health care team provides family-centered care for at-risk pregnancies in the Maternal-Fetal Medicine Center and the Birthplace. Together our care team includes maternal-fetal medicine specialists, neonatologists, neonatal nurse practitioners, genetic counselors, NICU nurses, respiratory therapists, licensed social workers, speech and physical therapists, lactation consultants, pharmacists, and nutritionists. All are committed to working closely with you to provide a personalized experience and seamless continuity of care.

To ensure continuity of care, we continue to follow infants who have been discharged from the NICU, closely monitoring their neurodevelopment to ensure, when indicated, that appropriate intervention occurs.

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