About the Division
About the Division of Neonatology
The Division’s three clinical services—transport, NICU and follow-up—continue to provide outstanding care despite the usual, never ending ebbs and flows that are characteristic of neonatal-perinatal medicine. The scope the Acute Care Transport Service continues to expand as the team transports an increasing number of children who are no longer neonates or infants. Research projects within the transport domain include quality of care during transport, implementation of best practices, and improvements for safe transport. One of the highlights of the year was the inaugural multidisciplinary T4 Conference—Triage, Transport, Treatment and Transition—held in October 2015.
The NICU continues to provide outstanding care for critically ill neonates with hypoxaemic respiratory failure, hypoxic-ischaemic encephalopathy, and multiorgan failure as a consequence of infection and other serious conditions. Approximately 40% of the NICU’s patients are surgical neonates—atresiae of the gastrointestinal tract and anterior abdominal wall defects—are the dominant congenital anomalies amongst this population in our NICU. Many neonates are admitted for surgical management of the complications of prematurity, especially necrotising enterocolitis. A care bundle has been implemented to reduce the incidence of this devastating condition and there has been an increased emphasis on newer approaches for its surgical management. Antibiotic and nitric oxide stewardship programs have yielded new insights about the use of these agents, facilitated the development of evidence-informed guidelines, and improved clinical practice. The research foci of Divisional faculty include chronic neonatal lung injury and pulmonary hypertension; developmental gastrointestinal physiology; the clinical efficacy of cardiovascular agents especially those used in the perioperative management of the haemodynamically significant patent ductus arteriosus; whole genome sequencing studies in newborns with congenital anomalies; and lung simulation for mechanical ventilation training. The highlight of the year was the transition from our Clinical Information Management System to KidCare on September 29, 2015. Computerised order entry was the most important of several new features that were implemented with this transition. The successful transition was the culmination of three years’ effort by many multidisciplinary teams within the Neonatology Program and beyond.
The scope of the Neonatal Developmental Follow-Up Clinic is expanding because of the increased interest in the developmental outcomes of neonates with congenital cardiovascular malformations. In collaboration with the Labatt Heart Centre, these children are being referred to the Clinic. Neonatologists and neurologists are collaborating on multiple studies documenting outcomes for neonates with acquired brain injury, congenital cardiovascular malformations and the impact of being born preterm on the developing brain. The expansion of the Clinic is expected to continue as a direct consequence of an increasing number of referrals and the desire to follow these children until they have reached school age.