{"id":20757,"date":"2024-11-06T15:19:52","date_gmt":"2024-11-06T15:19:52","guid":{"rendered":"https:\/\/global.sentec.com\/5-reasons-to-consider-transcutaneous-co2-monitoring-for-your-small-baby-unit\/"},"modified":"2025-03-12T21:31:49","modified_gmt":"2025-03-12T21:31:49","slug":"5-reasons-to-consider-transcutaneous-co2-monitoring-for-your-small-baby-unit","status":"publish","type":"sentec-articles","link":"https:\/\/global.sentec.com\/ja\/articles-and-resources\/5-reasons-to-consider-transcutaneous-co2-monitoring-for-your-small-baby-unit\/","title":{"rendered":"5 Reasons to Consider Transcutaneous CO2 Monitoring for Your Small Baby Unit"},"content":{"rendered":"

In a small baby unit, transcutaneous CO2 monitoring can support care teams in delivering the high level of care preterm babies require. The technology provides continuous CO2 monitoring, supporting timely assessments of respiratory status to aid in protecting the vulnerable brains and lungs of neonatal patients. Offering this monitoring noninvasively also helps minimize pain and blood loss, and supports care teams in protecting the fragile skin of their patients. Here, we\u2019ll explore these key benefits and how they can make a lasting impact on patients in a small baby unit.<\/p>\n<\/div><\/div><\/div><\/div><\/div>

Benefits of Transcutaneous Monitoring in Small Baby Units<\/span><\/h2><\/div>

Premature infants often require complex care that must carefully balance numerous needs and priorities. Here are five ways transcutaneous CO2 monitoring can support care teams navigating this level of care in a small baby unit:<\/p>\n<\/div><\/div><\/div>

\"\" Support Neuroprotection<\/span><\/h6><\/div>

Neuroprotection is crucial for premature infants because their developing brains are highly vulnerable to injury, especially brain bleeds like intraventricular hemorrhage (IVH). Prioritizing neuroprotective care strategies in a SBU can help prevent long-term neurological deficits and improve developmental outcomes for these fragile infants.<\/p>\n

Hypercarbia (high PCO2), hypocarbia (low PCO2), and fluctuations in CO2 levels all carry the risk of brain injury, including IVH, especially in the first three days of life.\u00b9 Given CO2’s role in blood pressure regulation and potential brain injury, close monitoring of patient ventilation is an important component of neuroprotective care. Transcutaneous CO2 monitoring allows SBU teams to maintain continuous visibility of CO2 levels, enabling teams to target effective gas exchange while making prompt adjustments to ventilatory support. This proactive approach can help maintain desired CO2 levels, preventing harmful fluctuations and safeguarding the fragile developing brains of these infants.<\/p>\n

Additionally, transcutaneous monitoring provides SBU teams with the flexibility to monitor their patients regardless of the ventilation method used, from high frequency ventilation to noninvasive options and bubble CPAP.<\/p>\n

In Practice: The University of Alabama\u2019s Golden Week Program<\/strong><\/p>\n

From 2014 to 2020, the University of Alabama at Birmingham Regional NICU implemented a quality improvement initiative aimed at reducing mortality and severe brain hemorrhages in extremely preterm infants. This program, which incorporated the early use of transcutaneous CO2 monitoring among other practices, successfully lowered the incidence of death or severe brain bleeding from 27.4% to 15% over a 27-month period.\u00b2<\/p>\n

Explore their results<\/a><\/p>\n<\/div>

\"\" Reduce pain and stimulation<\/span><\/h6><\/div><\/div><\/div>

<\/i><\/i><\/span>What is a Small Baby Unit?<\/span><\/a><\/h4><\/div>
\n

As survival rates and outcomes improve for premature infants, neonatal intensive care units (NICUs) now resuscitate babies born as early as 22- and 23-weeks. In some hospitals, this has led to the development of small baby units (SBUs), which are special care areas within the NICU designed to meet the needs of these extremely low birth weight (ELBW) and very low birth weight (VLBW) patients.<\/p>\n

The staff in these units are often highly trained, tasked with implementing specialized care strategies and guidelines developed to optimize care for the tiniest patients. SBUs often maintain a low patient-to-provider ratio, sometimes as low as 1:1. Additionally, these units are typically a separate, designated area of the NICU featuring dim lighting, low noise levels, and other elements designed to support development.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

Neuroprotection goes beyond preventing brain bleeds; pain and stimulation can also negatively impact a neonate’s development. Premature infants, due to their underdeveloped brains, cannot acclimate to pain or self-soothe like full-term infants, resulting in increased sensitivity and vulnerability.\u00b3<\/p>\n<\/div>

For these infants, frequent blood draws and other sources of pain have consistently demonstrated adverse effects on the long-term neurological and developmental outcomes<\/a>, including poorer mental development\u00a0<\/sup><\/sup>4 <\/sup> and cognitive outcomes.\u00a0<\/sup><\/sup>5 <\/sup>These results underscore the importance of implementing pain reduction strategies in the care of premature infants.<\/p>\n

In the NICU, the most effective way to minimize pain in infants is to minimize the number of painful procedures performed.\u00a0<\/sup><\/sup>6 <\/sup> Blood sampling is the most common painful procedure for neonates,\u00a0<\/sup><\/sup>7 <\/sup> primarily done to measure blood gases.\u00a0<\/sup><\/sup>8 <\/sup> By using transcutaneous CO2 monitoring, it is possible to maintain continuous visibility of crucial parameters while decreasing the need for painful blood draws.\u00a0<\/sup><\/sup>9 <\/sup> This approach can minimize repeated invasive procedures and, as a result, help avoid the associated negative outcomes.<\/p>\n<\/div>

In Practice: How Hershey Medical Center\u2019s NICU Reduced Blood Draws<\/strong><\/p>\n

In this whitepaper, clinicians from the Hershey Medical Center\u2019s Level IV NICU explore how, with proper education and implementation, transcutaneous monitoring can be an effective tool for reducing the need for blood draws in the NICU.<\/p>\n

Explore their practices<\/a><\/p>\n<\/div><\/div><\/div>

\"\"<\/p>\n<\/div><\/div><\/div>

\"\" Prioritize Lung Protection<\/span><\/h6><\/div>

Patients in a SBU frequently require some level of ventilatory support. However, the fragile, underdeveloped lungs of premature infants are particularly susceptible to negative outcomes from ventilation: failing to deliver enough volume can result in derecruitment and atelectasis, while delivering too much risks overdistension and volutrauma. This can often become a balancing act of competing priorities: brain and lung protection often remain in constant tension during a premature infant\u2019s NICU stay. The more underdeveloped the patient\u2019s organs, the more risk involved and the more difficult this balancing act becomes.<\/p>\n

As SBUs manage ventilatory support strategies for their patients, continuous visibility to CO2 can be a powerful, even vital, tool. This continuous insight can enable care teams to identify each infant’s safe window of support by targeting effective gas exchange, guiding necessary adjustments in pursuit of the gentlest ventilatory settings that adequately support the patient. Transcutaneous monitoring offers SBUs this continuous visibility, helping care teams work to safeguard their patients from potential lung damage.<\/p>\n<\/div>

\"\" Minimize Blood loss<\/span><\/h6><\/div>

One study found that 30% of neonates\u2019 circulating blood volume was drawn for lab work each week in their first six weeks of life.\u00a0<\/sup><\/sup>10 <\/sup> While frequent laboratory testing allows clinicians to closely monitor key parameters, like PCO2, it can end up being a significant source of blood loss for infants in the NICU. These procedures can be particularly concerning for premature patients in the SBU, who don\u2019t have much blood to give in the first place. Minimizing blood loss during care can help this and other complications associated with blood loss, such as the need for transfusions.<\/p>\n<\/div>

Transcutaneous monitoring enables noninvasive measurement of patients\u2019 CO2 levels, lessening the need for frequent blood draws without sacrificing visibility to this important parameter.\u00a0<\/sup><\/sup>9 <\/sup>\u00a0Although blood draws provide crucial information and remain a necessary tool in the NICU, efforts to reduce unnecessary blood loss where possible can make a significant impact for these delicate patients. Transcutaneous monitoring can be an impactful tool in these efforts<\/a>.<\/p>\n<\/div><\/div><\/div>

\"\" Protect Delicate Skin<\/span><\/h6><\/div>

In a small baby unit, safeguarding the skin is a top priority. Because of its delicate, underdeveloped nature, the skin of premature infants is susceptible to damage from skin-breaking procedures like blood draws. Repeated interventions such as heel sticks can result in complications like cellulitis, perichondritis, calcaneal osteomyelitis, and abscesses.\u00a0<\/sup><\/sup>11 <\/sup> By providing continuous, real-time CO2 readings, transcutaneous monitoring reduces reliance on blood draws, promoting less invasive care for these delicate patients.<\/p>\n

Twenty years ago, early transcutaneous monitors, which required sensors to operate at temperatures up to 44\u00b0C, often caused skin issues and needed frequent repositioning. Today\u2019s advanced systems operate at a lower temperature of 41\u00b0C, allowing sensors to stay in place for up to 8 hours and reducing the need for frequent adjustments. In addition, some attachment options designed specifically for small babies allow the sensor to be secured without adhesive, supporting visibility in those crucial first days, even in high humidity.<\/p>\n<\/div>

Sentec\u2019s Skin-Friendly Attachment Solutions <\/span><\/h3><\/div>

Sentec transcutaneous monitoring offers a range of skin-friendly attachment solutions designed for the delicate skin of neonatal patients.<\/p>\n<\/div><\/div><\/div>

<\/span><\/div><\/div><\/div>

MARe-MI<\/span><\/h3><\/div>

All-purpose attachment ring for mature, intact skin featuring acrylic-based adhesive<\/p>\n<\/div><\/div><\/div>

<\/span><\/div><\/div><\/div>

MARe-SF<\/span><\/h3><\/div>

All-purpose attachment ring featuring silicone based adhesive for fragile skin<\/p>\n<\/div><\/div><\/div>

<\/span><\/div><\/div><\/div>

Non-Adhesive Wrap<\/span><\/h3><\/div>

For gentle attachment in VLBW infants, especially in high-humidity environments<\/p>\n<\/div><\/div><\/div>

<\/span><\/div><\/div><\/div>

Contact Gel<\/span><\/h3><\/div>

Single-use contact gel that enables convenient workflow & supports infection control<\/p>\n<\/div><\/div><\/div><\/div><\/div>

Transcutaneous Monitoring in Your Small Baby Unit<\/span><\/h2><\/div><\/div><\/div>
<\/span><\/div><\/div><\/div>
For Your Team: The NICU Pocket Guide<\/h6>\n<\/div>

Transcutaneous CO2 monitoring can be a valuable tool for your small baby unit care. Our Clinical Pocket Guide on Transcutaneous CO2 Monitoring for Neonates<\/a> can assist your team in integrating this technology into your unit\u2019s protocols or enhancing its use to support patient care.<\/p>\n<\/div>