An infectious

Meet Sean 34 weeks

Patient overview:
- Born at 34 weeks, premature baby
- 2600 grams at birth
- Resuscitation required at birth, respiratory distress, a late onset sepsis with anuric acute kidney injury (AKI), and distributive shock

The first 24 hours

A critical journey of hope begins

Sean’s premature arrival along with his crying and grunting means that the labor and delivery staff is on the lookout for common problems seen in premature babies, such as cardiopulmonary instability. Immediately, pulse oximetry is used to track minute-by-minute HR and SpO2 levels. Sean’s oxygen saturation readings are low per neonatal resuscitation protocol and he requires CPAP respiratory support. 

He is moved to the NICU for continued management of mild respiratory distress.

first 24
after 24

24 hours & after

Medical marathons and milestone moments

Although Sean continues to require NIV+ noninvasive ventilation for his ongoing respiratory distress, his condition has stabilized over the past week. However, Sean’s nurse reports that he seems to be deteriorating with clusters of bradycardic events, no wet diapers for 24 hours, and lethargy. At the direction of his neonatologist, he undergoes a septic work-up and is started on antibiotics. Group B streptococcus (GBS) grows on hemoculture within 12 hours, and he is diagnosed with late onset sepsis (LOS). His condition worsens and he develops septic shock. Although he ultimately responds to the treatment, his course is complicated by anuric acute kidney injury (AKI) for which he requires dialysis. 

His neonatal sepsis escalates with an uncontrolled systemic inflammatory response activated by hostile stimuli; including desaturation, metabolic acidosis, and enteric bleeding which cascades to distributive shock.

NICU solutions

Products that support patients and provide critical information to the clinical team

Resuscitation monitoring

The lungs of an infant are the last organ to mature. As a result, babies born preterm often have underdeveloped lungs and need to be monitored for respiratory insufficiency — especially right at delivery. It is important to achieve just the right amount of oxygen and intervention per the neonatal resuscitation protocol (NRP).

Nellcor™ pulse rate (PR) readings are strongly correlated with ECG heart rate. In a head-to-head prospective observational comparative study with Masimo, Nellcor’s™ time to a stable oximeter signal was, on average, 12 seconds faster.1 With no recorded instances of false bradycardia1, (compared to Masimo recording false bradycardia in 35% of newborns tested1) the labor and delivery care team can rely on Nellcor™ pulse oximetry for fast and accurate results.

During Sean’s delivery, the team ensures a portable SpO₂ patient monitoring system called the Nellcor™ PM10N is ready to begin surveillance of Sean in labor and delivery. Sean is born and a gentle, accurate Nellcor™ OxySoft™ SpO2 sensor is promptly placed on his foot. The Nellcor™ system quickly detects continued low oxygen saturation, so Sean is resuscitated and moved into the NICU for respiratory support. 


Nellcor™ portable SpO₂ patient monitoring system, PM10N

Experience a small, lightweight, ergonomic handheld pulse oximeter to use wherever your patient is, including immediately following birth in labor and delivery. Nellcor™ portable SpO2 patient monitoring system also incorporates Nellcor™ digital signal processing technology to deliver accurate, reliable SpO2 and pulse rate values even during difficult monitoring conditions such as low perfusion and signal interference, including patient motion.

Nellcor™ PM10N portable patient monitoring system

Nellcor™ OxySoft™ SpO2 sensor

Our Nellcor™ OxySoft™ SpO2 sensor helps you stay connected to your patients and their data with bright LEDs on a flexible circuit that protects fragile skin. Our sensor has gained an improved signal acquisition and time to post during simulated low perfusion and thicker tissue.

  • First pulse oximetry sensor to use silicone adhesive. Removes 87% less skin protein2,3 when removed or readjusted
  • Easy to peel apart and reposition up to 18 times2,3
  • Sensors red LEDs have a 50% better signal acquisition in simulated low perfusion and thick tissue of neonatal feet2,3
  • 50% reduction in time to post2,3

The Nellcor™ pulse oximetry monitoring system should not be used as the sole basis for diagnosis or therapy and is intended only as an adjunct in patient assessment.

Respiratory care

The NICU is a difficult environment, and clinicians manage unique critical tasks like managing oxygenation within extremely tight ranges. Because of a neonate's fragile lungs, invasive tools are used as sparingly as possible.

Sean’s post-delivery respiratory distress needs respiratory support. His respiratory therapist puts him on Puritan Bennett™ 980 ventilator with NIV+ software to reduce the uncertainty around effective pressure delivery.


Puritan Bennett™ 980 ventilator

A multipurpose ventilator for noninvasive and invasive ventilation to help clinicians manage neonatal respiratory care:

  • Uses a lung protective ventilation strategy that accurately controls tidal volume, synchrony, and leak management4 to help prevent atelectasis, diaphragmatic dysfunction, and lung injury5
  • Can provide accurate assessment monitoring and delivery of the volume with or without the use of a proximal flow sensor6

Puritan Bennett™ 980 ventilator

NeoMode 2.0 software for the Puritan Bennett™ 980 ventilator

Helps clinicians provide ventilatory support to neonates weighing as little as 300 grams by delivering tidal volumes as small as 2 mL. The NeoMode 2.0 software was developed specifically for neonates to address and improve some of the issues critical to their care and safety, such as accurate breath delivery, responsive triggering, lower elevated oxygen preset for procedures, effective alarm management, and automatic leak compensation.

Please refer to the instructions for use for the indications, contraindications, warnings, risks, and precautions associated with the Puritan Bennett™ 980 ventilator and software referenced in these materials.

AKI monitoring

A regional desaturation event can indicate a major problem in an organ. Neonatologist rely on the ability to measure acute alterations in hemodynamics, regional oxygen saturation (rSO2), and oxygen metabolism, so they can intervene quickly.

Due to Sean’s kidney injury, he is being monitored with the INVOS™ 7100 regional oximetry system and INVOS™ infant regional oximetry sensors to generate continuous, noninvasive readings of regional blood oxygen levels. INVOS™ 7100 regional oximetry system provides an early alert that Sean is experiencing distributive shock and his doctors are able to respond quickly.


INVOS™ 7100 regional oximetry system

Designed to help quickly identify desaturation events and improve the clinician’s ability to intervene sooner. Because seconds matter.

  • Clinically validated design and our proprietary algorithm allow INVOS™ technology to measure acute alterations in hemodynamics, regional oxygen saturation (rSO2), and oxygen metabolism — markers that can help identify physiological changes more quickly than other indicators.
  • Patient can be assessed for adequate delivery and consumption of oxygen at the  organ-specific, regional tissue bed.

INVOS™ 7100 regional oximetry system

INVOS™ infant regional oximetry sensors

A soft, small sensor designed for fragile neonatal skin for use anywhere on the body. INVOS infant regional saturation sensors are applied to the skin’s surface, and are user and patient friendly, making monitoring of ischemic threats to the brain and body possible. By reporting venous weighted regional hemoglobin oxygen saturation (rSO2) in tissue directly beneath the sensor, the INVOS regional oximetry system reflects oxygen remaining after tissue demand has been met.

The INVOS™ 7100 regional oximetry system should not be used as the sole basis for diagnosis or therapy and is intended only as an adjunct in patient assessment.

AKI treatment

Acute kidney injury (AKI) is very serious and requires immediate treatment, however it is often reversible if it is found and treated quickly. 

Sean is diagnosed with AKI and begins temporary hemodialysis to remove waste from his blood while his kidneys cannot. The Carpediem™ cardio-renal pediatric dialysis emergency machine is specifically designed for pediatric patients — providing continuous renal replacement therapy (pCRRT) for Sean’s acute kidney injury.

Carpediem™ cardio-renal pediatric dialysis emergency machine

The first of its kind, the Carpediem™ system offers a miniaturized extracorporeal CRRT specifically designed for fragile, low weight pediatric patients weighing 2.5 to 10 kgs.

  • pCRRT system removes waste products and decreases excess fluid
  • Closely monitors fluid balance: +/- 1 g high-precision scales8
  • Enables use of small catheter sizes9
  • Reduces blood cell and vessel damage while providing necessary and adequate diffusive clearances: 2–50 mL/minimum low blood flow rates7,8,10

CRRT procedures performed for critically ill infants using previously available technology are not optimal, largely because dialysis machines available in the United States are not designed to treat these small, fragile patients, and can potentially expose them to many risks.

This new system is designed specifically for these patients which enables increased precision of neonatal CRRT treatment and, potentially, reduces these risks. We are grateful to be the first site in the United States with this technology to help the children in our care.”

– Stuart L. Goldstein, M.D.,
Professor of pediatrics and director, Center for Acute Care Nephrology at Cincinnati Children’s Hospital Medical Center

sean quote


A matter of heart

Support and partnerships

A supportive family for those first months of life

The NICU team is more than just a group of highly trained and specialized medical professionals. It’s a genuine smile at the sight of a milestone achieved. It’s an emotional and sometimes heartbreaking end to a shift. It’s a supportive shoulder and life coach to a concerned parent struggling with their new reality. It is a family. At Medtronic we strive to be more than just a medical technology company; we aim to be a supportive member of that family.

Clinical support

We offer online medical education and product training from our highly experienced clinical field representatives.

eLearning courses are available for many of our NICU products.

eLearning courses

Hospital support

Medtronic offers an innovative and broad portfolio to support the NICU. Quality and sustainability are of utmost importance. We design our sensors, cables, monitors, ventilators, and dialysis products for seamless compatibility, durability, and ease of use — so you can put your focus on your patients not the devices.

We offer comprehensive, professional reimbursement services to secure and maintain coverage and payment.

Learn more

Our partners

Our partnerships with societies and nonprofits that serve the NICU help drive research, community connection, and solutions to the specific challenges that are faced on a regular basis.

Our partners include:

National Association of Neonatal Nurses


Neonatal Heart Society

American Nurses Association

Hope for HIE

American Association for Respiratory Care

  These narratives feature fictional patients, based on real clinical scenarios and product use. At all times, it is the professional responsibility of the practitioner to exercise independent clinical judgment in a particular situation. Changes in a patient’s disease and/or medications may alter the efficacy of the therapy, or product features. Results may vary. 


Khoury, R., Klinger, G., Shir, Y., Osovsky, M., Bromiker, R., Monitoring oxygen saturation and heart rate during neonatal transition. comparison between two different pulse oximeters and electrocardiography. Journal of Perinatology, 2021; 41(4):885-890.


Internal head-to-head bench testing against MaxN.


Based on head-to-head testing with MaxN – CSR 2021 0312v1 S20-12.


Keszler M. Mechanical ventilation strategies. Seminars in Fetal and Neonatal Medicine. 2017;22(4):267-274. 


Dargaville PA, Tingay DG. Lung protective ventilation in extremely preterm infants. Journal of Paediatrics and Child Health. 2012:48(9):740-746. 


Puritan Bennett™ 980 ventilator operations manual.


Ronco C, Garzotto F, Ricci Z. CA.R.PE.DI.E.M. (Cardio-renal pediatric dialysis emergency machine): evolution of continuous renal replacement therapies in infants. A personal journey. Pediatr Nephrol. 2012;27(8):1203–1211.


Carpediem™ dialysis system [Operator’s manual]. Minneapolis, MN: Medtronic; 2021.


Vidal E, Cocchi E, Paglialonga F, et al. Continuous veno-venous hemodialysis using the cardio-renal pediatric dialysis emergency machine™: first clinical experiences. Blood Purif. 2018;31:1–7.


Garzotto, F, Zaccaria M, et al. Choice of catheter size for infants in continuous renal replacement therapy: Bigger is not always better. Pediatric Critical Care Medicine. 2019;20(3): 170-179.