Medical care & clinical practicePreterm and ill infants, treated in the neonatal intensive care unit have multiple medical clinical conditions, resulting in an extremely vulnerable patient group. (1–4) Enormous improvements in neonatal care during the last years have also made care increasingly complex.
The most important neonatal event is the postnatal adaptation to extrauterine life during which air breathing is established and circulatory changes take place. Difficulties may occur with transition in situations such as preterm birth and following perinatal asphyxia, accounting for much of the associated neonatal mortality and morbidity. (5–8) Other conditions that are of great relevance for preterm and other ill infants are bronchopulmonary dysplasia, respiratory distress syndrome, suspected early onset neonatal sepsis, hypoglycaemia, hypoxic ischaemic encephalopathy, persistent pulmonary hypertension of the newborn infant, neonatal jaundice, Retinopathy of Prematurity, and vitamin K deficiency bleeding.
Additionally, infants requiring neonatal intensive care constitute a high-risk population for developing brain injury, particularly full term and preterm infants exposed to hypoxia-ischaemia, CNS infections, or with congenital anomalies. Therefore, early recognition of disturbed brain function or structural brain injury is important in the institution of preventive or treatment strategies, and appropriate follow-up. Early identification of impaired function will improve clinical management and long-term functional outcomes. (9–14)
The Topic Expert Group on Medical care and clinical practice develops standards on the prevention, diagnosis and management of the main medical conditions and challenges affecting preterm or ill babies. Additionally, standards on specific clinical procedures and techniques are developed.
