1. Smith, Heather E. PhD, RN, NNP-BC, CNS

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Over the last few years, live bedside webcams have become more common in the neonatal intensive care unit (NICU) to provide secure video access to NICU parents while separated from their hospitalized infants.1 One hospital system, IWK Health Centre, in Halifax, Nova Scotia, Canada, is looking to lessen the strain on the parent-child relationship by taking the bedside webcam approach to the next level. In 2016, the IWK NICU piloted a program called Chez NICU that provided around-the-clock access for NICU parents to visually connect with their infants, learn about the NICU through educational tools, and allow communication between parents and healthcare providers.2,3 The technology is designed to encourage a direct and closer connection between parents and their infants, in particular to increase health outcomes of their infants. The software was developed in conjunction with Cisco Canada and can be used on smartphones, tablets, and personal computers. In line with the purpose of the Canadian Atlantic Innovation Fund,4 the Canadian government announced recently that it will financially provide $3 million to support the Chez NICU project with the intent to improve and enhance the technology, making it available eventually for commercial sale.5 The Chez NICU project is led by Marsha Campbell-Yeo, PhD, RN, NNP-BC, and will aim to hire 7 full-time individuals and 5 student positions.5



Several years ago, healthcare providers noticed that tubing for parenteral, enteral, and medical devices at large was not individualized to keep someone from making a connection mistake. Unfortunately, as a result, errors occurred such as administering breast milk through an infant's intravenous catheter. Because of the likelihood for error, groups were formed such as the Global Enteral Device Supplier Association and standards were developed to require specific tubing connectors to reduce connecting errors.6 Enteral feeding devices must meet standards of the International Organization for Standardization (ISO), which are upheld by the Food and Drug Administration (FDA).7 Any new medical device before being manufactured and sold must be reviewed by the FDA and meet the necessary rigor for approval or exemption.


Medela is a well-known brand name in the NICU space, known for its breast pump, breast care, and enteral feeding products. Over the years, Medela has adopted the ENFit connectors that are the standard ISO model for tubing and syringe connectors.8 Until now, its product line did not include a low-dose tip syringe, which is needed for small oral doses of medication and feedings that are often warranted in the NICU. Recently, Medela received FDA 510(k) clearance of this new ENFit low-dose syringe product that will increase accuracy of administered small doses.9,10



Three-dimensional (3D) printing is a computer-driven mechanism that can build a variety of products one layer at a time. Each of these thin layers allows the final product customization at every level of development.11 In the last 5 years, 3D printing has become more mainstream and, not long ago, has made its debut in becoming a useful tool to care for neonates requiring surgery. Traditionally, surgical practice performing surgery on neonates has been acquired by using mannequins and by gaining real-life experience.12 Although mannequins provide a good substitution for providing realistic anatomical landmarks, there are severe limitations when it comes to understanding the pressure applied and the delicacy of the neonatal body. In addition, many neonates require surgical intervention due to congenital anomalies. Many surgeons are capable of preparing for surgery based on magnetic resonance images and computed tomographic scans, but if these congenital anomalies are discovered in utero, it can be difficult to fully appreciate the anatomical variances until they are standing in the operating room. This is where 3D printing can assist in preparing the surgeon and, in turn, the neonate for success. 3D printing has been a useful tool in surgically correcting cardiac defects13 and providing skeletal replicas for surgeons to appreciate the size and strength of the neonatal body.12 As 3D printing evolves, it is likely that it will not remain just a replica to human anatomy but become a new method of developing usable anatomical structures. How this will affect the NICU is not fully known but makes the future of medicine exciting!




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3. Canadian Healthcare Technology. New system will use video to monitor babies in NICU. http:// Accessed March 10, 2017. [Context Link]


4. Atlantic Canada Opportunities Agency. Atlantic Innovation Fund. http:// Accessed March 13, 2017. [Context Link]


5. Government of Canada. Investments in innovative neonatal care help families bond. https:// Accessed March 7, 2017. [Context Link]


6. Global Enteral Device Supplier Association. Welcome to GEDSA. Accessed March 13, 2017. [Context Link]


7. Food and Drug Administration. Reducing risks through standards development for medical device connectors. https:// Accessed March 16, 2017. [Context Link]


8. Medela, Inc. Medela syringes with ENFitTM connectors. http:// Accessed March 14, 2017. [Context Link]


9. Deken A, Davis B, Giles A, Koelper C, McMichael D, Phillips P. Dose accuracy-performance testing of enteral, oral, ENFit(R), and ENFit LDT syringes. Accessed March 13, 2017. [Context Link]


10. Medela, Inc. Medela introduces complete enteral feeding system with launch of new product. http:// Published March 9, 2017. Accessed March 9, 2017. [Context Link]


11. Aufieri R, Picone S, Gente M, Paolillo P. 3D printing in neonatal care. Ital J Pediatr. 2015;41(suppl 1):A1. doi:10.1186/1824-7288-41-S1-A1. [Context Link]


12. 3D Hubs. 3D printed newborn mannequins aim to increase surgical success for neonatal patients. http:// Accessed March 14, 2017. [Context Link]


13. Materialise. Saving a newborn with the support of 3D printing. http:// Accessed March 16, 2017. [Context Link]