CHOC’s Surgical NICU Offers Pioneering Coordinated Treatment

ICHOC Children's Surgical NICU nfants needing surgery require special attention, and a unique feature of CHOC’s Neonatal Intensive Care Unit (NICU) provides just that.

CHOC’s Surgical NICU, a dedicated space within the NICU, uses a comprehensive approach to care for these tiny patients. A coordinated treatment protocol – used in many adult intensive care units nationwide – has shown to result in fewer patient complications, better outcomes and faster discharges. And, CHOC’s Surgical NICU physicians and staff continue to research new ways to make the care even better.

“CHOC has one of the only two Surgical NICUs like it at any children’s hospital in the country,” says Dr. Mustafa H. Kabeer, who with Dr. Irfan Ahmad, a neonatologist, co-directs the Surgical NICU at CHOC.

“We have a room dedicated with eight beds and a second room with two beds that allow for surgeries to be done right there in the NICU. It’s a unique setting in which we have multi-disciplinary, coordinated care.”

“Babies in the NICU are very critical to start with and things can change minute by minute. When you add in the risks of surgery, it becomes more complex. We coordinate care through better communication with physicians and the nurses and the family. We involve all of these groups so everybody is on the same page. We have joint rounds with residents and fellows, and have initiatives on research and teaching, with monthly lectures on select topics. We are collecting data on outcomes and how the babies do,” says Dr. Kabeer.

Dr. Ahmad adds, “The experience has been so positive. We are all really happy with the care our patients are receiving. The surgeries and anesthesia have become safer.”

In a new effort, CHOC’s Surgical NICU team has begun a new research project to examine better pain control for babies following surgery. “This is going to be really big and is being planned by Dr. Kabeer from surgery, myself from neonatology, and Dr. Rebecca Sangster from anesthesia,” says Dr. Ahmad.

Other projects include investigating ways to decrease the occurrence of hypothermia, or low body temperatures, for babies having surgery. In addition, the Surgical NICU staff is maintaining a patient database that will help the staff design future quality improvement projects and clinical studies.

The Surgical NICU is special in other ways. Patient rounds there often include a dozen or more specialists who join the physician and nurses. “These rounds are very different than what goes on anywhere else. We try to educate the families about what this means and how unique this is,” says Dr.  Kabeer.

Babies in CHOC’s Surgical NICU receive consistent and coordinated care from a multidisciplinary healthcare team that includes neonatologists, nurses, surgeons, respiratory therapists, nutritionists and other specialists who may be needed. Parents and family members round out the team. The family joins the clinicians to discuss care plans, share information and make care decisions. Each patient receives a well-coordinated and consistent treatment plan.

Pediatric surgeons perform many types of surgeries in the Surgical NICU, including lung and thoracic surgeries, robotics surgeries, head and neck surgeries, repairs of umbilical and inguinal hernias, among a variety of different operations.

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