Building a pediatric neurocritical care program: a multidisciplinary approach to clinical practice and education from the intensive care unit to the outpatient clinic.
We describe our 10-year experience developing the Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program at Northwestern University Feinberg School of Medicine. The neurocritical care team includes intensivists, neurologists, and an advanced practice nurse who have expertise in critical care neurology and who continue care in long-term follow-up of intensive care unit patients in a dedicated neurocritical care outpatient clinic. Brain-directed critical care requires collaboration between intensivists and neurologists with specific expertise in neurocritical care, using protocol-directed consistent care, and physiological measures to protect brain function. The heterogeneity of neurologic disorders in the pediatric intensive care unit requires a background in the relevant basic science and pathophysiology that is beyond the scope of standard neurology or critical care fellowships. To address this need, we also created a fellowship in neurocritical care for intensivists, neurologists, and advanced practice nurses. Last, we discuss the implications for pediatric neurocritical care from the experience of management of pediatric stroke and the development of stroke centers.
Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Department of Pediatrics, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Critical Care, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: m-wainwright@northwestern.edu.
Mark S
MS
Wainwright
Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Department of Pediatrics, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Michele
M
Grimason
Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Department of Pediatrics, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Joshua
J
Goldstein
Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Department of Pediatrics, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Critical Care, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Craig M
CM
Smith
Department of Neurology, Seattle Children׳s Hospital, Seattle, WA.
Catherine
C
Amlie-Lefond
The Rehabilitation Institute of Chicago, Chicago, IL.
Gadi
G
Revivo
Division of Critical Care, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Zehava L
ZL
Noah
Division of Critical Care, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Zena L
ZL
Harris
Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Department of Pediatrics, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Neurology, Ann & Robert H. Lurie Children׳s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Leon G
LG
Epstein
D000554:Ambulatory Care Facilities; D002648:Child; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D009462:Neurology / Q000193:education*; D010372:Pediatrics / Q000193:education*