NNCC Harvey Sarnat NNCC Fellowship University of Calgary
Luis Bello Espinosa Innovation in Neonatal NeuroCritical Care Lab In memory of Dr. Luis Bello-Espinosa, 1957 to 2026

Dr. Luis Bello-Espinosa Innovation in Neonatal Neuro-Critical Care Education Lab

Democratizing access to innovative, affordable brain-health education for trainees worldwide, combining clinical expertise with the latest technology and cross-disciplinary collaboration.

Painted portrait of Dr. Luis Bello-Espinosa
Dr. Luis Bello-Espinosa1957 to 2026
1,000+Workshop participants worldwide
16 countriesIndia, China, US, UK, Canada, Netherlands, Ireland, Italy, Saudi Arabia, UAE, Kuwait, Oman, Morocco, Brazil, Colombia & Ecuador
28% → 7%Reduction in missed HIE cases
In Memoriam

Dr. Luis Bello-Espinosa, 1957 to 2026

The lab carries his name because the work it teaches would not exist without him.

Luis Bello-Espinosa was a pediatric neurologist and epileptologist. He died suddenly on July 11, 2026, in Orlando, Florida, at the age of 68. He was born in Cartagena, Colombia, and took his medical degree at the Universidad Metropolitana de Barranquilla. Training in pediatric neurology and epilepsy followed in New Jersey and New York, then at the Mayo Clinic. He practised for ten years in Canada, and afterwards joined Orlando Health Arnold Palmer Hospital for Children, where he cared for children with epilepsy until his death.

In Calgary he worked in the Section of Pediatric Neurology at the University of Calgary and the Alberta Children's Hospital Research Institute. He was instrumental in establishing the Calgary neonatal neuro-critical care program. With Dr. Juan Pablo Appendino he took on round-the-clock reading of the continuous video EEG studies that NICU nurses were setting up at the perinatal centre. That commitment, made long before remote neurophysiology coverage was routine anywhere, is what turned nurse-initiated brain monitoring from an idea into a working service.1,2

Families remembered his bow ties, and they remembered that he gave them his whole attention. At his service on July 18, 2026, mourners were asked to wear bow ties or dark blue in his honour.

  1. Bashir RA, Espinoza L, Vayalthrikkovil S, Buchhalter J, Irvine L, Bello-Espinosa L, Mohammad K. Implementation of a neurocritical care program: improved seizure detection and decreased antiseizure medication at discharge in neonates with hypoxic-ischemic encephalopathy. Pediatr Neurol. 2016;64:38–43. PubMed
  2. Goswami I, Bello-Espinosa L, Buchhalter J, Amin H, Howlett A, Esser M, Thomas S, Metcalfe C, Lind J, Oliver N, Kozlik S, Mohammad K. Introduction of continuous video EEG monitoring into 2 different NICU models by training neonatal nurses. Adv Neonatal Care. 2018;18(4):250–259. PubMed
A newborn's seizures do not wait for daytime, and neither did he. Everything this lab now teaches about neonatal brain monitoring rests on that willingness.
Dr. Khorshid Mohammad with Dr. Luis Bello-Espinosa

Dr. Luis Bello-Espinosa, right, with Dr. Khorshid Mohammad.

The bow tie

The bow tie was not an affectation, or not only one. It is an old marker of the bedside physician, part care for appearance and part practicality, since a bow tie does not swing forward onto a patient or a cot rail when you lean in to examine a baby. Neurologists took to it as readily as anyone, and Dr. Bello-Espinosa wore his everywhere. Colleagues who could not immediately place his name could always place the tie.

Dr. Luis Bello-Espinosa on NNCC membership. Plays muted.
The Work Behind the Name

Nurse-initiated cvEEG, and what it changed

Calgary was among the first centres to place the setup of continuous video EEG in the hands of NICU nurses, with an epileptologist reading each study remotely at any hour of the day. Two peer-reviewed reports came out of that model, both with Dr. Bello-Espinosa as an author. Together they gave the field its early published evidence that the approach sharpens neonatal seizure diagnosis while reducing antiseizure medication exposure.

Improved seizure detection, less medication at discharge

Bashir RA, Espinoza L, Vayalthrikkovil S, Buchhalter J, Irvine L, Bello-Espinosa L, Mohammad K. Implementation of a neurocritical care program: improved seizure detection and decreased antiseizure medication at discharge in neonates with hypoxic-ischemic encephalopathy. Pediatr Neurol. 2016;64:38–43.

  • 157 neonates with hypoxic-ischemic encephalopathy, studied for two years before and two years after 72-hour cvEEG became protocol
  • Electrographic seizure detection increased significantly (P = 0.016)
  • After cvEEG, 5 of 37 infants (14%) with no clinical seizures were found to have electrographic seizures. None had been identified before
  • Fewer infants went home on any antiseizure medication (P = 0.008)
  • Mean phenobarbital burden fell (P = 0.04), with no rise in other antiseizure medications

Training neonatal nurses to run cvEEG in two NICU models

Goswami I, Bello-Espinosa L, Buchhalter J, Amin H, Howlett A, Esser M, Thomas S, Metcalfe C, Lind J, Oliver N, Kozlik S, Mohammad K. Introduction of continuous video EEG monitoring into 2 different NICU models by training neonatal nurses. Adv Neonatal Care. 2018;18(4):250–259.

  • 192 cvEEG studies across two neonatal intensive care units served by a single neuro-critical care team
  • Nurses were trained to apply scalp electrodes, to troubleshoot the equipment, and to recognise abnormal amplitude-integrated EEG patterns
  • A central network let the epileptologist read studies remotely and give feedback the same shift
  • Time to start brain monitoring fell by 31.5 hours
  • Electrographic seizure detection rose from 20% to 34%. Clinical misdiagnosis of seizures fell from 65% to 36%
31.5 hFaster to start brain monitoring after nurse training
20% → 34%Electrographic seizure detection
65% → 36%Clinical misdiagnosis of neonatal seizures

Our Vision

Democratizing access to innovative, affordable brain-health education for trainees worldwide.

Our Mission

To create state-of-the-art teaching modules by combining clinical expertise with the latest technology and cross-disciplinary collaboration.

Through Collaboration

We bridge medicine and engineering with students and professionals from Computer Science & Software Engineering, Bioengineering & Mechanical Engineering, and 3D Design.

About the Lab

Locally built, globally used

The Neonatal Neuro-Critical Care Program, under the umbrella of the ACH Neuro-Critical Care Program, has developed the Dr. Luis Bello-Espinosa Innovation in Neonatal Neuro-Critical Care Education Lab. The lab has produced cutting-edge, innovative simulators and models, all developed locally, that have been used across the globe for clinical-care application, quality improvement and research.

Flagship Model

Cranial Ultrasound Simulation Model

Computer-based simulators and ultrasound-able 3D-printed brain phantoms, developed in partnership with the Sonographic Clinical Assessment of the Newborn (SCAN) Program.

The cranial ultrasound simulators let learners practise ultrasonography using a bank of images from patients with normal cranial structures and multiple pathologies, plus ultrasound-able 3D-printed heads with landmark brain structures. Preloaded images are selected via the computer program, while a mannequin with sensors embedded under the scalp lets the probe select corresponding image sequences to simulate real-life scanning. Components include a laptop connected to a sensor within the probe. The tools familiarize trainees with probe orientation, image-optimization skills, and ultrasound-machine knobology.

Brain Phantoms

Ultrasound-able 3D-printed heads with simplified key internal brain structures, the lateral ventricles, caudo-thalamic notch, and choroid plexus.

3D-printed cranial ultrasound brain phantom

Computer-Based Cranial Ultrasound Simulators

  • 3D-printed heads with pressure sensors at the anterior and mastoid fontanels.
  • 3D-printed probes with Arduino sensors that interact with the sensors in the printed heads.
  • Cranial ultrasonography software translates probe movements into images, simulating a real cranial ultrasound study.
Computer-based cranial ultrasound simulator

Global implementation

Used in conferences and hands-on workshops across sixteen countries, India, China, the US, the UK, Canada, the Netherlands, Ireland, Italy, Saudi Arabia, the UAE, Kuwait, Oman, Morocco, Brazil, Colombia and Ecuador, with more than 1,000 participants in total. We follow up with centres afterward to help them build their programs and sustain learned skills.

Clinical skills & education

Integrated into our neonatology fellowship program. All of our neonatology fellows now train in neonatal cranial ultrasonography, compared with no formal training before the models were developed.

Quality improvement

Used to standardize the preterm brain-injury definition among radiologists and neonatologists. Two workshops in Calgary and Toronto brought together representatives from every Level III centre in the country; the resulting taskforce created a consensus practice guideline to standardize diagnosis and imaging in preterm infants nationwide.

Research & what's next

We tested the efficacy of simulation-based learning in gaining and sustaining ultrasonography skills and published the results in a peer-reviewed journal. In development: smart tracing of lateral-ventricle borders for surface-area measurement, side-by-side MRI/US slicing, interactive self-learning quizzes, user-contributed case libraries, expanded phantoms (corpus callosum, cerebellum, third ventricle), and cerebral-artery Doppler functionality.

Vascular Imaging

Cerebral Arteries Doppler Model

The anterior and middle cerebral artery simulator features the anterior and middle cerebral arteries embedded in a realistic, ultrasound-compatible brain phantom.

Anatomy included

Anterior Cerebral Artery, Middle Cerebral Arteries, and Cerebral Peduncle.

Simulation mechanism

A peristaltic pump generates flow, while a 20 cc syringe allows manual control of pulsation.

Learning objectives

  • Generating 2D images
  • Mastering Doppler acquisition (Color and Pulse Wave)
  • Measuring Resistive (RI) and Pulsatility (PI) indices

Implementation: used in training at international workshops.

Cerebral arteries Doppler model

MCA Model

A dedicated middle-cerebral-artery model for Doppler training and demonstration.

MCA model slide
Procedural Skill Maintenance

PHVD Measurement & Reservoir Tapping Model

As surgical intervention for post-hemorrhagic ventricular dilatation (PHVD) becomes rare, maintaining competency in tapping the ventricular reservoir is a challenge. We developed a "just-in-time" teaching model that includes:

  • A teaching video
  • A reservoir simulator, a reservoir connected to an IV fluid bag hidden inside a mannequin body, with a surgical incision and suture that resemble the real reservoir surgical site

Implementation

Used as a "just-in-time" teaching tool each time we face a case of reservoir insertion, and at international workshops such as the Pediatric Academic Societies meeting and the American Academy of Pediatrics District VIII Section of Neonatal-Perinatal Medicine.

Digital Tools

Smartphone Apps

Free bedside tools for newborn brain health, on Google Play and the App Store.

HUS Diagnostic and NeuroSono

We converted the consensus viewpoint developed between Neonatology and Radiology into a smartphone application, made free on Google Play and the App Store, to improve compliance and decrease variability. Using AI, we then developed an all-in-one tool for GMH-IVH prevention, management and diagnosis.

HIE Cooling Calculator

The updated version is now live on both stores. Eligibility follows the 2026 American Academy of Pediatrics clinical report on therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy. The calculator also supports the aEEG-based eligibility criteria used in the UK and across Europe, and it is aligned with the Canadian Paediatric Society update currently in preparation.

  • Eligibility updated to the 2026 AAP clinical report
  • Supports aEEG-based eligibility criteria used in the UK, Europe and elsewhere
  • Aligned with the Canadian Paediatric Society update in preparation
  • Free on both stores. It supports clinical judgement, it does not replace it
  1. Committee on Fetus and Newborn. Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy: clinical report. Pediatrics. 2026;157(2):e2025073627. DOI

PHVD App

A bedside tool for measuring and following cerebral ventricular size in newborn infants. It standardizes how ventricular indices are recorded, so that serial measurements can be compared over time rather than read in isolation. The reference charts and management thresholds clinicians already rely on become something reachable in seconds at the incubator.

Grounded in evidence

  1. El-Dib M, Limbrick DD, Inder T, Whitelaw A, Kulkarni AV, Warf B, Volpe JJ, de Vries LS. Management of post-hemorrhagic ventricular dilatation in the infant born preterm. J Pediatr. 2020;226:16–27.e3. PubMed
  2. Brouwer MJ, de Vries LS, Groenendaal F, Koopman C, Pistorius LR, Mulder EJH, Benders MJNL. New reference values for the neonatal cerebral ventricles. Radiology. 2011;262(1):224–233. PubMed

Work from our group

  1. Leijser LM, Scott JN, Roychoudhury S, Zein H, Murthy P, Thomas SP, Mohammad K. Post-hemorrhagic ventricular dilatation: inter-observer reliability of ventricular size measurements in extremely preterm infants. Pediatr Res. 2020;90(2):403–410. PubMed
  2. Musiime GM, Mohammad K, Momin S, Kwong GPS, Riva-Cambrin J, Scott J, Zein H, Hendson L, Leijser LM. Prediction of post-hemorrhagic ventricular dilatation trajectory using a growth mixture model in preterm infants. Pediatr Res. 2024;97(1):213–221. PubMed
  3. Musiime GM, Hendson L, Mohammad K, Kwong GPS, Riva-Cambrin J, Benlamri A, Tang S, Scott JN, Momin S, Zein H, Leijser LM. Neurodevelopmental impairment in preterm infants following progressive post-hemorrhagic ventricular dilatation. J Perinatol. 2026;46(6):986–992. PubMed
HIE Identification

Neonatal Neurological Examination Simulators & Modules

Built to improve identification of infants who suffered perinatal asphyxia and are eligible for therapeutic hypothermia, where the window of opportunity to start treatment is short.

Targeted Neurological Examination Teaching Videos

With formal family consent, full neurological-examination videos were recorded for normal and abnormal newborns, then edited and integrated into one targeted neurological examination to improve HIE identification.

Neonatal neurological examination simulator

Therapeutic Hypothermia Eligibility Tool

A free smartphone application that serves as a checklist and decision-making tool for cooling eligibility.

Targeted Neuro-Exam Virtual Reality Module

Recorded videos were converted into animation scenarios used to create a virtual-reality module in which trainees can observe and perform the targeted neurological examination.

Neurological Examination Mannequins

In collaboration with computer scientists, mechanical engineers and bioengineers, a neurological-examination model was developed to simulate tone assessment and posture. The project won Best in Clinical Category at the 2019 Health Hack competition.

Neurological examination mannequin
28% → 7%Missed HIE cases after implementation, without increasing annual volume
2 + 1Workshops in Kuwait, plus a nursing NNCC workshop in Calgary
RCTRandomized controlled pilot trial published (PubMed)

The combined package of teaching modules and simulators was used in the Southern Alberta Neonatal Outreach Program, where we visited all Level I and II referring centres and conducted sessions on improving HIE identification.

Neuro-Monitoring

Neonatal EEG Teaching Modules & Simulator

Teaching videos demonstrate how to place EEG electrodes and generate a good-quality signal, with step-by-step "how-to" tutorials on starting an EEG study and troubleshooting. In collaboration with computer scientists, software engineers and mechanical engineers, an EEG simulator was developed to simulate EEG set-up.

Clinical impact

Using these modules, videos, documents, small-group training, workshops and the simulator, we trained NICU nurses to set up EEG studies, helping establish neuro-monitoring in the NICU. Nurse-initiated EEG significantly decreased time to study initiation, which in turn led to a significant reduction in anti-seizure medication use and improved seizure diagnosis.

Neonatal EEG simulator

Teaching EEG Set-up with Simulation & Live Children

The EEG and neuro-exam simulators were used at our local, national and international workshops, with our own children volunteering as simulation models.

Teaching EEG setup with simulation
Artificial Intelligence

AI NNCC Tools

Open-access decision-support tools developed by the NNCC Innovation & Research group.

Bring brain-health innovation to your centre

Train with us, collaborate on a model, or bring our simulators and modules to your workshop. We help centres worldwide build and sustain neonatal neuro-critical care skills.

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