Understanding the inflammatory response of the neonate: Clinical implications for caregivers in the neonatal intensive care unit

Nurses who care for preterm infants within the neonatal intensive care unit (NICU) face a multitude of challenges. An issue of major importance is supporting the immature immune response that when left unchecked makes young and preterm infants especially vulnerable to infection. Research has shown that the neonate's inflammatory response is moderately effective yet not well differentiated, which can lead to additional tissue destruction. This article examines the pathophysiology of the inflammatory process and discusses the influence that inflammation has on the infant before and after birth. Links between neonatal sepsis and neurologic insults such as intraventricular hemorrhage and periventricular leukomalacia are discussed. These insults have been associated with poor neurodevelopmental outcomes. Nursing interventions and management strategies are provided to best support the infant during this critical process. An understanding of the infant's immune system and the inflammation process will enhance the neonatal caregiver's ability to consider and provide preventative measures in routine care practices.