Protecting brains and saving futures guidelines: A prospective, multicenter, and observational study on the use of telemedicine for neonatal neurocritical care in Brazil

Autor: Gabriel Fernando Todeschi Variane, Maurício Magalhães, Rafaela Fabri Rodrigues Pietrobom, Alexandre Netto, Daniela Pereira Rodrigues, Renato Gasperini, Guilherme Mendes Sant’Anna
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Male
Physiology
Maternal Health
Video Recording
Neonatal Care
Pediatrics
Infant
Newborn
Diseases
Geographical locations
Study Protocol
Spectrum Analysis Techniques
Medicine and Health Sciences
Multicenter Studies as Topic
Prospective Studies
Clinical Neurophysiology
Brain Mapping
Multidisciplinary
Brain
near-Infrared Spectroscopy
Electroencephalography
Telemedicine
Electrophysiology
Observational Studies as Topic
Bioassays and Physiological Analysis
Brain Electrophysiology
Practice Guidelines as Topic
Medicine
Female
Brazil
Imaging Techniques
Science
Neurophysiology
Neuroimaging
Infrared Spectroscopy
Medical Services
Research and Analysis Methods
Seizures
Intensive Care Units
Neonatal
Humans
Electrophysiological Techniques
Infant
Newborn
Infant
Biology and Life Sciences
Neonates
South America
Neurophysiological Monitoring
Health Care
Women's Health
Clinical Medicine
Neonatology
People and places
Delivery of Health Care
Developmental Biology
Neuroscience
Zdroj: PLoS ONE, Vol 17, Iss 1 (2022)
PLoS ONE
PLoS ONE, Vol 17, Iss 1, p e0262581 (2022)
ISSN: 1932-6203
Popis: Background Management of high-risk newborns should involve the use of standardized protocols and training, continuous and specialized brain monitoring with electroencephalography (EEG), amplitude integrated EEG, Near Infrared Spectroscopy, and neuroimaging. Brazil is a large country with disparities in health care assessment and some neonatal intensive care units (NICUs) are not well structured with trained personnel able to provide adequate neurocritical care. To reduce this existing gap, an advanced telemedicine model of neurocritical care called Protecting Brains and Saving Futures (PBSF) Guidelines was developed and implemented in a group of Brazilian NICUs. Methods A prospective, multicenter, and observational study will be conducted in all 20 Brazilian NICUs using the PBSF Guidelines as standard-of-care. All infants treated accordingly to the guidelines during Dec 2021 to Nov 2024 will be eligible. Ethical approval was obtained from participating centers. The primary objective is to describe adherence to the PBSF Guidelines and clinical outcomes, by center and over a 3-year period. Adherence will be measured by quantification of neuromonitoring, neuroimaging exams, sub-specialties consultation, and clinical case discussions and videoconference meetings. Clinical outcomes of interest are detection of seizures during hospitalization, use of anticonvulsants, inotropes, and fluid resuscitation, death before hospital discharge, length of hospital stay, and referral of patients to specialized follow-up. Discussion The study will provide evaluation of PBSF Guidelines adherence and its impact on clinical outcomes. Thus, data from this large prospective, multicenter, and observational study will help determine whether neonatal neurocritical care via telemedicine can be effective. Ultimately, it may offer the necessary framework for larger scale implementation and development of research projects using remote neuromonitoring. Trial registration NCT03786497, Registered 26 December 2018, https://www.clinicaltrials.gov/ct2/show/NCT03786497?term=protecting+brains+and+saving+futures&draw=2&rank=1.
Databáze: OpenAIRE
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