Critical Care Ultrasound Should Be a Priority First-Line Assessment Tool in Neurocritical Care

Cardiac Point-of-Care Ultrasound in Pediatric Neurocritical Care: A Case Series

BACKGROUND

Pediatric brain injury is accompanied by hemodynamic perturbations complicating the optimization of cerebral physiology. Point-of-care ultrasound (POCUS) uses dynamic real-time imaging to complement the physical examination and identify hemodynamic abnormalities in preload, contractility, and afterload conditions, but the contribution of cardiac POCUS in the context of pediatric brain injury is unclear.

METHODS

We reviewed cardiac POCUS images integrated in clinical care to examine those with neurological injury and hemodynamic abnormalities.

RESULTS

We discuss three children with acute brain injury and myocardial dysfunction identified using cardiac POCUS by bedside clinicians.

CONCLUSIONS

Cardiac POCUS may have an important role in caring for children with neurologic injury. These patients received personalized care informed by POCUS data in attempts to stabilize hemodynamics and optimize clinical outcomes.

Core competencies in neurocritical care training in China: consensus developed by a national Delphi consensus survey combined with nominal group technique

OBJECTIVES

To define the core competencies essential for specialist training in neurocritical care in China.

DESIGN

Modified Delphi method and nominal group (NG) technique.

SETTING

National.

PARTICIPANTS

A total of 1094 respondents from 33 provinces in China participated in the online survey. A NG of 11 members was organised by the Neuro-Critical Care Committee affiliated with the Chinese Association of Critical Care Physicians and the National Center for Healthcare Quality Management in Neurological Diseases.

RESULTS

1094 respondents from 33 provinces in China participated in the online survey. A formal list containing 329 statements was generated for the rating by a NG. After five rounds of NG meetings and one round of comments and iterative review, 198 core competencies (54 on neurological diseases, 64 on general medical diseases, 42 on monitoring of practical procedures, 20 on professionalism and system management, five on ethical and legal aspects, three on the principles of research and certification and 10 on scoring systems) formed the final list.

CONCLUSION

By using consensus techniques, we have developed a list of core competencies for neurocritical care training, which may serve as a reference for future specialist training programmes in China.