INTERNATIONAL NEWS

A Report on the Joint Meeting of the Neurocritical Care Society of India and AIIMS Neuroanaesthesia and Neurocritical Care Update

 

Vanitha Rajagopalan, MD, DM; Keshav Goyal, MD, DM; Ashish Bindra, MD, DM; and Arvind Chaturvedi, MD

Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre and JPN Apex Trauma Centre

All India Institute of Medical Sciences (AIIMS), New Delhi, India


Vanitha Rajagopalan, MD, DM


Keshav Goyal, MD, DM


Ashish Bindra, MD, DM


Arvind Chaturvedi, MD

The Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, hosted the 3rd annual conference of the Neurocritical Care Society of India (NCSI) and AIIMS Neuroanaesthesia and Neurocritical Care Update 2022 from October 7th – 9th, 2022 at Hotel Pride Plaza, New Delhi. The presence of dignitaries, an impressive array of intellectuals from across the globe, the support of sponsors, and an assemblage of carefully selected, well-researched, and well-presented scientific content on the subject, all came together to help Team AIIMS to conclude this huge endeavor admirably. The conference was applauded for the 9 pre-conference workshops, two orations, four-panel discussions, two video sessions, and a debate, besides the inaugural and valedictory ceremony. This joint conference has, without a doubt, made the academic fraternity richer, with the additional literature in the form of scholarly works on the subject of neuroanaesthesia and neurocritical care. This three-day event offered opportunities to the participating delegates to interact with academicians, scholars, and experts from all over the world who deliberated upon and covered topics revolving around our theme of emerging challenges and advances in neurocritical care. The three days comprised incisive and insightful discussions on various facets of neurocritical care, which were highly engaging, innovative, up-to-date, and comprehensive in content, and witnessed a truly magnificent exchange of knowledge. The conference owes its success to the organizing secretary of the event, Dr. Keshav Goyal, under the able leadership of Dr. Arvind Chaturvedi (Organizing Chairman) and the hard work put in by the entire AIIMS team. The enthusiasm of the organizing committee was immense, as this was the first physical meeting of the NCSI and was long overdue because of COVID-19 restrictions.

The hands-on training was offered to residents/ fellows and neuro-nurses during the workshops like hemodynamic monitoring, mechanical ventilation, transcranial doppler, EEG for neurointensivist, brain death, radiology for neurointensivist, POCUS and advanced airway held on October 6, 2022. The workshops were coordinated by various expert faculty and attended by resident doctors and fellows from within the country and abroad. The neuro-nursing CME was attended by over 100 nurses who enthusiastically participated in the interactive case-based discussions and hands-on training and received useful insights on practical aspects of the management of critically ill patients in the Neuro ICU.

The first day of the scientific deliberation began with a talk on “Widening horizons of Neurocritical Care: Scope and way forward” followed by “Key studies in neurocritical care: Review of five years”. The second session comprised pre-recorded lectures by international faculty, who were available online to address questions and clear doubts on some latest available evidence on important topics on the management of external ventricular drains, ischemic and hemorrhagic stroke, and brain ultrasound. Next was a panel discussion on perioperative recovery, followed by topics covering the nitty gritty of the brain and systemic interactions. All the sessions were greatly cherished by the delegates and triggered great discussion.

Dr. Chandrasekhar Deopujari delivered the prestigious ‘Prof Saini-Dash-Bithal Oration’, who spoke on “Neurocritical Care: Past, Present, and Future.” Video sessions comprised of comprehensive demonstration for assessment of intracranial pressure, cerebral autoregulation diaphragmatic function, and deep venous thrombosis. The next session focussed on EEG, delayed cerebral ischemia, and active rehabilitation in Neuro ICU. The panel discussion provided an accurate and deep understanding of dilemma and decision-making in acute ischemic stroke. The next session focused on mechanical ventilation in cervical spine injury and brain injured with acute respiratory distress syndrome.

Chief Guest Prof S S Saini inaugurated the event. The Guests of Honor were Prof H H Dash and Prof Uma Maheshwara Rao. Among the other distinguished dignitaries were Prof Rajesh Malhotra, Prof Shailesh B Gaikwad, Prof Shashi Srivastava (NCSI President), and Dr. V Ponniah (Secretary NCSI).

The second day began with a discussion on brain death and therapies to restore consciousness in patients with severe brain injuries. This was followed by an elaborate discussion on bedside sepsis management and brain concussion. Next, Dr. Gussippie Citerio discussed the implications and observations made during “CENTER- TBI” study. ‘Prof Uma Maheshwara Rao Oration’ was deliberated by Dr. Nicola Latronico who sermonized on “ICU- acquired Acute Neuromuscular Disorders and Muscle Weakness: Are they of interest for the Neurocritical Care Community?” The subsequent session saw extensive deliberations on cortical venous thrombosis, temperature management in brain injury, and non-convulsive status epilepticus. This was followed by a lucid panel discussion on the management of subarachnoid hemorrhage.

There was another interesting round of ‘video sessions’ on infrared pupillometry, swallowing assessment, and jugular venous oximetry. This was followed by a series of pre-recorded online lectures by renowned international experts on paroxysmal sympathetic hyperactivity and biomarkers in brain injury, besides a discussion on the development of training modules in neurocritical care. Debates on TEG- based Transfusion strategy and “Hemicraniectomy in Malignant Stroke in Elderly (>60 years) were wrangled. The much-awaited talk on “Emerging Technologies and Innovations in NCC” was deliberated next and was followed by a general body meeting and the Gala Dinner.

The final day began with talks on transfusion triggers in the neurocritical care role of antithrombotics in intracranial hematoma and also included a discussion on recommendations in acute stroke with atrial fibrillation. Next was an update session on practical applications and included tracheostomy care, DVT chemoprophylaxis, and advances in acute neurorehabilitation. Besides this, the scientific session extensively covered the management of infections, neuromuscular disorders, sedation, and weaning protocols in neurointensive care units. An interesting session on “CHI Running: Way to Healthy Life” followed. Finally, the conference discussed the lessons learned from the pandemic and a keynote talk on humanizing ICU care. The scientific program concluded with a case discussion on common electrolyte disturbances in neuro ICU.

All three days witnessed a large number of paper and poster presentations. Residents also participated with great zest in the quiz competitions. The conference concluded with the valedictory function; the paper, poster, and quiz competition winners were awarded certificates of appreciation and cash prizes. The meeting was an excellent source of updated information, and the sessions were highly appreciated.


Figure1: Various moments during the meeting


Figure 2: Neuro-nursing CME


Figure 3: Different workshops

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