Special rooms of the CHOC Neonatal Intensive Care Unit are designated for the Neurocritical NICU, where we have the expertise and equipment to carefully treat and prevent neurological issues such as seizures, asphyxiation and brain damage. Our pediatric board-certified neurologists are available 24/7 to partner with our neonatologists to make a specialized treatment plan together for our patients.
Long-Term Video EEG Monitoring
In the NICU, 12 beds are equipped for long-term video EEG monitoring, which is used to evaluate a baby’s brain activity and behavioral activity for an extended period of time. This long-term monitoring is crucial for detecting newborn seizures that are not always physically apparent. Patients are monitored around the clock by registered EEG technologists, and neurologists are always available for consultation when questions arise about an infant’s behavior and physical signs. Our neurologists can also remotely access the video and EEG monitoring equipment to assist in treatment planning.
Based on the results of the studies and work-ups, our pediatric epileptologists can detect seizures in an asymptomatic infant and work with the neonatal team to develop individualized treatment recommendations. Learn more about our Comprehensive Epilepsy Program.
Whole Body Cooling
The Neurocritical NICU uses advanced hypothermia treatment, a proven technique for minimizing the effects of hypoxic-ischemic encephalopathy in newborns. Treatment must begin within six hours of birth. We offer the Blanketrol® III Whole Body Cooling System. The NICU also offers a CritiCool transport body cooling device that allows our Transport Team to begin hypothermic therapy at the moment we accept an infant from an outlying facility. That means we can quickly reach more newborns in a wider geographic area with this specialized treatment.
There are three categories of HIE: mild, moderate and severe. Most babies that have mild HIE recover with no disability. About 40-70 percent of babies with moderate HIE have some form of lifelong disability like cerebral palsy, impaired brain function and seizures. The most severe cases almost always result in severe disabilities that may include mental retardation, severe motor dysfunction and seizures. Severe HIE can also cause death. Your baby’s doctor will talk with you about how severe your baby’s HIE is, and what to expect in the days and weeks ahead.
Most of the time, the cause of HIE is unknown. Bleeding or problems with the mother’s uterus, the placenta or umbilical cord could cause HIE.
• Blanketrol® III Whole Body Cooling System: Your baby will lie on a special cooling blanket that has water running through it. The water temperature can be adjusted to warm or cool the body. Normal body temperature is 98.6°F (37°C). Your baby will be maintained in a range between 91°F -95°F (32.5°C-35°C) during the cooling process.
• Olympic Cool-Cap System: Your baby will wear a special hat (like a swimming cap) that has water running through it. The water temperature can be adjusted to warm or cool the body. Your baby will be maintained in a range between 92°F -95°F (33.5°C-35°C) during the cooling process.
Your baby may need medicine and blood products to treat seizures, potential infection, blood pressure and to keep your baby calm. He or she may need the help of a breathing machine, and special IV access for monitoring, treatment and nutrition. There will be no milk feeding during treatment.
Your baby’s skin may be pale or blotchy and may feel cool to the touch. You may not be able to hold your baby in your arms because it may increase the baby’s temperature. The treatment is noninvasive and is monitored closely to be sure that the baby is comfortable.
• An electroencephalogram (EEG) after treatment will look at the brain’s electrical activity and possible signs of seizures that are common in babies with HIE.
• Brain imaging (MRI) will evaluate the brain’s structure and extent of brain injury.