Document Detail

Neurodevelopmental care in the NICU.
MedLine Citation:
PMID:  12454906     Owner:  NLM     Status:  MEDLINE    
Neurodevelopmental care, which is any NICU intervention undertaken to improve neurodevelopmental outcome, includes NICU design, nursing routines, nursing care plans, management of pain, feeding methods and, most importantly, encouraging parental involvement with their NICU infant. Recognition that sensory stimulation can overwhelm preterm infants and increase physiologic signs of stress led to attempts to reduce sensory input. More recent approaches judiciously add back soothing sensory input (e.g., therapeutic touch, soft music). Circadian light/dark cycles and physical activity improve preterm growth. Attention to infant positioning and handling affects physiologic variables and joint mobility, if not functional motor abilities. A highly organized system of care for NICU infants is Als' NIDCAP (i.e., Neonatal Individualized Developmental Care and Assessment Program). Although NIDCAP may reduce need for respiratory support and hospital length of stay, it does not significantly influence neurodevelopmental outcome at 2-3 years. Pain management includes benign interventions (e.g., nonnutritive sucking, oral glucose), but the prolonged use of narcotics must be balanced against the consequences of sedation and dependency. The foremost challenge for NICUs remains parent disenfranchisement. Kangaroo care, which involves parent/infant skin-to-skin contact, improves preterm growth, decreases nosocomial infections and may shorten hospital length of stay. A great deal of work needs to be done to identify and demonstrate efficacy of specific interventions and changes that humanize the NICU, encourage parental involvement, support infant development and optimize preterm neurodevelopmental outcomes.
Susan Aucott; Pamela K Donohue; Eileen Atkins; Marilee C Allen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Mental retardation and developmental disabilities research reviews     Volume:  8     ISSN:  1080-4013     ISO Abbreviation:  Ment Retard Dev Disabil Res Rev     Publication Date:  2002  
Date Detail:
Created Date:  2002-11-27     Completed Date:  2003-04-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9517974     Medline TA:  Ment Retard Dev Disabil Res Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  298-308     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Wiley-Liss, Inc.
Eudowood Division of Neonatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-3200, USA.
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MeSH Terms
Breast Feeding
Central Nervous System Diseases / prevention & control*,  rehabilitation*
Health Facility Environment
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal / organization & administration*
Intensive Care, Neonatal
Mother-Child Relations
Professional-Family Relations
Sucking Behavior

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