News Video | Policy | GPs | Hospitals | Medical | Mental Health | Welfare | Search


Neorocritical care centres could save lives

10 May 2005

The lives of tens of thousands of people with brain injuries could be saved, with a better quality recovery, at less cost, through the introduction of specialised neurocritical care centres, according to a leading British anaesthetist.

There is now clear evidence that such specialist centres could significantly improve the quality of survival, Professor David Menon said in Auckland today.

Neurocritical care is intensive or critical care of patients whose primary problem is in the nervous system, most commonly the brain. Common causes of such disease include head trauma, stroke, brain haemorrhage, meningitis, and diseases of the nerves and muscles.

Professor Menon, Professor of Anaesthesia at Cambridge University, was speaking at the Annual Scientific Meeting (ASM) of the Australian and New Zealand College of Anaesthetists (ANZCA), being attended by 1,000 anaesthetists, intensivists and pain medicine specialists from around the world. The theme of the meeting is "Improving Outcomes".

He said that research in recent years had increasingly demonstrated the efficacy of specialist neurocritical treatment, particularly in the field of acute brain injury.

Standard guidelines had been developed by several expert bodies in the late 1990s, after an assessment of the various treatment options then in use.

The US Brain Trauma Foundation had later estimated that, based on these guidelines, 20,000 lives could be saved each year in the USA alone, and clear benefits had been demonstrated since under protocols broadly based on the American guidelines.

"More recently (2002/03) there have been numerous reports of significant improvements in outcome from evidence based management of severe head injury, compared with historical controls," Professor Menon said.
"According to two relevant studies, there were clear improvements in the proportion of patients experiencing favourable outcomes - from 40.4 per cent to 59.6 per cent in severe head injury, and from 40 per cent to 84 per cent in all head injured patients.
"These data suggest that good quality neurocritical care has its most consistent impact not on survival but on the more desirable goal of quality of survival.
"It is also clear that these results are best achieved by professional intensivists," Professor Menon said.

Arguments for neurocritical specialisation included the fact that clinical teams who frequently cared for patients with acute brain injury were more likely to have knowledge of secondary damage, and would better understand the pathophysiology they treat. As well, specialisation often attracted greater volumes of patients and a greater case-load was very likely to improve expertise in the area, as it did in others.

While the examples listed above referred to specialist stand-alone neurocritical care units, it was entirely possible for high quality neurocritical care to be delivered in some dedicated "general" intensive care units.

"Neurocritical care is not a label - it is a way of life which recognises the special needs of the acutely ill neurological patient and uses the available knowledge to maximise outcomes in this group," Professor Menon said.
"The availability of high quality intensive care in this context is an investment that pays for itself many times over in improved outcome and reduced costs for rehabilitation and support services during the later stages of the illness.
"For example, good intensive care can mean the difference between a head injured teenager being dead or alive, bed-bound or mobile in a wheelchair, and suffering from severe learning difficulties or leading a near normal life," he said.

Professor Menon said there already were a number of specialised neurocritical care units in the USA, the UK and Europe that concentrated on brain and associated injury or illness.


© Scoop Media

Culture Headlines | Health Headlines | Education Headlines


NZ On Air TV Funding: More Comedy Comes Out Of The Shadows

Paranormal Event Response Unit is a series conceived by Jemaine Clement and Taika Waititi as a TV spin-off from their highly acclaimed feature film What We Do In The Shadows. More>>


Mars News: Winners Announced For The 2016 Apra Silver Scroll Awards

Wellington singer-songwriter and internationally acclaimed musician Thomas Oliver has won the 2016 APRA Silver Scroll Award with his captivating love song ‘If I Move To Mars’. More>>


Scoop Review Of Books: Salt River Songs by Sam Hunt

Colin Hogg, a longtime comrade of Sam, writes in his Introduction that, ‘There is a lot of death in this collection of new poems by my friend Sam Hunt. It’s easier to count the poems here that don’t deal with the great destroyer than it is to point to the ones that do.’ More>>

Electronica: Restoring The World’s First Recorded Computer Music

University of Canterbury Distinguished Professor Jack Copeland and UC alumni and composer Jason Long have restored the earliest known recording of computer-generated music, created more than 65 years ago using programming techniques devised by Alan Turing. More>>


Scoop Review Of Books: Almost Getting Away With Murder

The Black Widow by Lee-Anne Cartier: Lee-Anne Cartier is the sister of the Christchurch man found to have been murdered by his wife, Helen Milner, after an initial assumption by police that his death, in 2009, was suicide. More>>

Howard Davis: Triple Echo - The Malevich/Reinhardt/Hotere Nexus

Howard Davis: The current juxtaposition of works by Ralph Hotere and Ad Reinhardt at Te Papa perfectly exemplifies Jean Michel Massing's preoccupation with the transmigration of imagery in a remarkable triple echo effect... More>>

Get More From Scoop



Search Scoop  
Powered by Vodafone
NZ independent news