NICU practice and Evidence-Based Research is constantly changing. Many of the practices I have seen over the past 9+ years have changed with updates, new technology, procedures, and treatments, with a movement to push our patient population forward with improved outcomes!
Here are a few topics to consider when searching for a research project, paper, or developing an abstract for your project! Many of these are controversial with a lot of different research supporting various outcomes.
NICU Research Project Ideas
DOUBLE JEOPARDY. WHAT DO WE KNOW AND WHAT CAN WE DO?
Common comorbidities of prematurity.
Intraventricular hemorrhage
Bronchopulmonary Dysplasia
Necrotizing Enertocolities
Retinopathy of Prematurity
Sepsis
Congenital heart Disease (CHD)
NEC! WHAT FACTORS INCREASE THE RISK OF NEC?
Standardization of assessments and treatments, Pneumoatosis, Is Clonic Pneumotosis real?, Treatment and feeding decisions, Guidelines, Antibiotics, Parenteral Nutrition, Vascular Access, Imaging Modalities, Hemodynamics, disease entity, restriction of systemic blood flow, generalized cyanotic state, Congenital Heart Disease (CHD).
https://www.nature.com/articles/pr2016215
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181543/
SMALL BABY STANDARDIZATION OF CARE
The formation and focus on standardizing ELBW and VLBW care. Guidelines, standardization, and streamlined care. Feedings, humidity, positioning, weights, lab draws central line management, RDS management, guidelines for incubations/extubations, weaning from isolette to crib, developmental considerations by gestational age.
https://engagegrowthrive.com/small-baby-care-specialist-program/
https://pubmed.ncbi.nlm.nih.gov/34330869/
PROBIOTICS!
The use of probiotics in practice (to use or not to use them). Gut flora. The pros and cons. Latest research in preventing NEC. Is this a preventative measure? Which probiotic products to consider? Lactobacillus, dual strains, and possible side effects or contraindications.
https://www.sciencedirect.com/science/article/abs/pii/S0378378219302932
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303425/
https://www.degruyter.com/document/doi/10.1515/jpm-2019-0268/html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805101/
PDA TREATMENT
Treatment of PDA. When to treat it and what modalities to treat it with…Indomethacin, PICCOLO PDA closure device, PEEP, etc). Risk vs Benefit. Clinical signs and symptoms.
https://www.sciencedirect.com/science/article/abs/pii/S0022347618309181
https://www.sciencedirect.com/science/article/abs/pii/S0146000518300326
SKIN TO SKIN
Skin to skin (myth-busting nicu dynamics when parents can’t hold). Developmental considerations. How to support families during the initial times with inability to hold baby.
https://www.sciencedirect.com/science/article/abs/pii/S1751485118302356
https://connect.springerpub.com/content/sgrnn/37/6/343.abstract?implicit-login=true
https://connect.springerpub.com/content/sgrnn/36/2/89?implicit-login=true
PAIN MANAGEMENT IN THE NEONATE
Anesthesia / Sedation! What is too much? What is not enough? Neurodevelopment perspectives with Gestational age & disease process. Nociceptive stimuli. Neuroapoptosis. Pain consequences with unrelieved pain, sleep, fatigue, and inflammatory response. Pre and Post-op considerations. The first line of pain relief modalities. Benzodiazepines, Opiates, Alpha 2 Agonists (Dexmedetomidine, Clonadine), Sweeties, Positioning etc.
https://www.nature.com/articles/jp201788
https://www.sciencedirect.com/science/article/abs/pii/S0146000516301161
BLOOD PRESSURE GOALS & STANDARDIZATION
Lack of standardization within the NICU patient population. What is too low? What is too high? Treating symptoms. What line of hemodynamic modalities to turn to? (Epi / Vasopressin / Dopamine)
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0041-1726123
https://www.sciencedirect.com/science/article/abs/pii/S0022347620302869
VENTILATOR STRATEGIES
Specific considerations for Gestational age, disease-specific treatments. Optimal PEEP, Low peak inflation/TV. Use of surfactant. Surfactant deficiencies (RDS), Corticosteroids, Alkalosis etc.
https://www.nature.com/articles/s41372-022-01399-1
SATURATION TARGET GOALS
Optimizing neurodevelopment, Target pre ductal SpO2. Oxygen should be used like any other drug; with potential benefits and side effects. Positioning considerations.
https://fn.bmj.com/content/96/2/F93.short
PALLIATIVE CARE
Multidisciplinary approach. Women facing pregnancies with a diagnosis of complex congenital or life-threatening conditions. Limitations in choices. Support during pregnancy, delivery, post-partum, and beyond.
https://journals.lww.com/co-pediatrics/Abstract/2017/04000/Neonatal_palliative_care.3.aspx
PRETERM INFANTS WITH CHD
Congenital Heart Disease issues. Cyanosis (TOF & TGA), pulmonary venous obstruction, (TAPVD, MS), Preoperative care, Preoperative pulmonary vasculature/reactivity (Trisomy 21, post RSV, transitional circulation). Neurodevelopment risk associated with prematurity. Restricted oxygen and insufficient nutrient delivery in utero.
BREAST MILK PRODUCTION & BREASTFEEDING INITIATIVES
The push for breast is best (doesn’t always work in the NICU). Breast milk production, the latest Evidence-Based Research to support mothers.
Hope this list helps you in your NICU Research! These are all very relevant in our NICU care with continued improvements in Evidence-Based Research! The more minds and research we can put to these topics the better. Feel free to drop your suggestions and comments below!
Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012 and works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey in married life & juggles work, school, and content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com