For newborns who have spent their critical first days in neonatal intensive care units (NICUs), clinicians can minimize transport-related risks with a dedicated system that enables MR imaging without leaving the NICU.
Inder
"With a complementary MR imaging tool, we do not have to leave the sanctuary of the NICU with our babies for an MR imaging procedure," said Terrie Eleanor Inder, MBChB, chair of the Department of Pediatric Newborn Medicine and the Mary Ellen Avery Professor of Pediatrics in Newborn Medicine at Harvard Medical School. "We can stay in the 'safe NICU' floor."
While hospital staff make every effort to minimize infection risk, newborns who must be moved through the hospital to the MR imaging suite are highly susceptible to complications related to clinical instability as well as to exposure to infectious microorganisms and cross-contamination from imaging equipment that serves the larger patient population.
A study by Osman Bastug, MD, and colleagues, published in 2016 in The Journal of Maternal-Fetal & Neonatal Medicine, found that 27% of neonatal patients suffered complications after being transported for radiology services. For newborns in need of MR studies, in-unit systems like Aspect Imaging's Embrace® can help by keeping newborns within the controlled environment of the NICU.
"We use Embrace to define brain injury and analyze brain development and we use this information to communicate risk with the family and tailor rehabilitation after discharge," Dr. Inder said.
Embrace is designed to be placed within the NICU. Dr. Inder said that prior to the COVID-19 pandemic, they used the Embrace system to evaluate babies in a research setting. "Now we use it for both research and all clinical use," she said.
Aspect Imaging developed Embrace to increase timely access to services, while many NICUs have begun to incorporate services including pharmaceutical, laboratory, respiratory and even surgical suites within the department. Now, with infectious disease risk a more acute concern than ever, Embrace not only offers convenience in workflow; it now provides access that can mean a better chance at survival for vulnerable infants.
Ben-David
"We have learned that the Embrace is faster and easier to use for our nursing staff and that the clinical read provides highly important information to our clinicians," Dr Inder said. "And the Aspect product support staff have been incredibly helpful and at our elbow."
Eliel Ben-David, MD, section chief of Neuroradiology at Sha'are Zedek Medical Center in Jerusalem, said that while his preference is to use a high-field magnet in MR imaging, he and his team now understand that a 1-Tesla magnet will give clinicians valuable information with little to no risk. The facility at Sha'are Zedek was originally a beta site for Embrace, and then a study site. Now the team uses the scanner for clinical applications as well.
"Adapting to images from a lower field magnet is a process, but a very quick one," Dr. Ben-David said. "Today, after numerous cases where it made an impact on medical decisions, I can't imagine working without the Embrace scanner."
"We care about the newborn brain and we want to understand if this baby has brain injury or risk for the future for neurodevelopmental disability," Dr. Inder said. "We also want to understand how our treatments may influence the risk of injury in all babies receiving care in our NICU."
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