Search Program
Organizations
Contributors
Presentations
Special Topic and Curated Session
Science of Neurocritical Care
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionThe course will discuss common errors made when writing a manuscript for publication in a peer reviewed journal and how to avoid them. They can be avoided by paying careful attention to: picking a good topic or question, following the Instructions for Authors, stating a clear focused objective, avoiding “me too” papers, biases in retrospective reviews, Sample size/statistical power, limitations of administrative databases, asking meaningful prognostic questions, proper description of statistical methods, and more.
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
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Poster
Intracerebral Hemorrhage
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Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Coma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
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Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Pediatric
Networking Event
Poster
Coma
Top Scoring Poster
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
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Medical Issues, Pharmacology, and Coagulopathy
Networking Event
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Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Neuromonitoring and Technology
Distinguished Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Coma
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
134: Multimodal Monitoring in Patients with Large Vessel Occlusion not Amenable to Revascularization
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
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Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Coma
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
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Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Coma
Top Scoring Poster
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
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Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Emerging and Other Topics
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
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Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
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Seizures/EEG
Networking Event
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Seizures/EEG
Networking Event
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Seizures/EEG
Networking Event
Poster
Emerging and Other Topics
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
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Subarachnoid Hemorrhage
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Subarachnoid Hemorrhage
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Subarachnoid Hemorrhage
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Subarachnoid Hemorrhage
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Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Emerging and Other Topics
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Emerging and Other Topics
Top Scoring Poster
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
CNS Infections/Inflammatory
Networking Event
Poster
Emerging and Other Topics
Top Scoring Poster
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
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Emerging and Other Topics
Networking Event
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Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
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Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
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Head and Spine Trauma
Networking Event
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Head and Spine Trauma
Networking Event
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Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
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ICU Organization, Staffing, and Education
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ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
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ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
Networking Event
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ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
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Intracerebral Hemorrhage
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Intracerebral Hemorrhage
Networking Event
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Intracerebral Hemorrhage
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Intracerebral Hemorrhage
Networking Event
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Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
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Ischemic Stroke
Networking Event
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Ischemic Stroke
Networking Event
Poster
Ischemic Stroke
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
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Medical Issues, Pharmacology, and Coagulopathy
Networking Event
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Medical Issues, Pharmacology, and Coagulopathy
Networking Event
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Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
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Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Networking Event
Poster
Neurosurgical and Peri Operative Management
Networking Event
Poster
Neurosurgical and Peri Operative Management
Networking Event
Poster
293: Cytokines and Chemokines as Biomarkers of Pediatric Traumatic Brain Injury Severity and Outcome
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Pediatric
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
299: Non-Convulsive Status Epilepticus In Severe TBI Patients At Level-I Apex Trauma Centre In India
Seizures/EEG
Networking Event
Poster
Head and Spine Trauma
Top Scoring Poster
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Seizures/EEG
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Top Scoring Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Subarachnoid Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Top Scoring Poster
Networking Event
Poster
Ischemic Stroke
Top Scoring Poster
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Medical Issues, Pharmacology, and Coagulopathy
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Neuromonitoring and Technology
Top Scoring Poster
Networking Event
Poster
Neuromonitoring and Technology
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Pediatric
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Pediatric
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Pediatric
Top Scoring Poster
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Seizures/EEG
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Seizures/EEG
Top Scoring Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Top Scoring Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Top Scoring Poster
Networking Event
Poster
Subarachnoid Hemorrhage
Top Scoring Poster
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Networking Event
Poster
Brain Death and Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
Post-Cardiac Arrest
Networking Event
Poster
CNS Infections/Inflammatory
Networking Event
Poster
Coma
Distinguished Poster
Networking Event
Poster
Coma
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Coma
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Post-Cardiac Arrest
Top Scoring Poster
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Emerging and Other Topics
Networking Event
Poster
Head and Spine Trauma
Distinguished Poster
Networking Event
Poster
Head and Spine Trauma
Distinguished Poster
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
CNS Infections/Inflammatory
Top Scoring Poster
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
Head and Spine Trauma
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
Coma
Top Scoring Poster
Distinguished Poster
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
ICU Organization, Staffing, and Education
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Intracerebral Hemorrhage
Networking Event
Poster
Coma
Top Scoring Poster
Distinguished Poster
General Session
Head and Spine Trauma
Breakout Session
Delivery, Quality and Safety
APP Practice
Diversity, Equity, and Inclusion
Global Neurocritical Care
Informatics
Patient Education
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionBias in Artificial Intelligence and Machine Learning (AI/ML) algorithms presents a significant challenge in neurocritical care, potentially leading to inequitable patient outcomes and treatment disparities. This session will delve into the complex issue of bias in AI/ML models deployed in neurocritical care settings. Attendees will explore the various sources of bias, including data collection practices, algorithm design, and societal factors, and their impact on decision-making processes. Through case studies and real-world examples, participants will gain insights into how bias manifests in AI/ML applications, such as differential diagnostic accuracy across demographic groups or unequal access to healthcare resources. Moreover, the session will discuss strategies for detecting, mitigating, and preventing bias in AI/ML models, ranging from algorithmic fairness techniques to diverse and representative dataset curation. By fostering a deeper understanding of bias in AI/ML, this session aims to empower attendees to champion fairness and equity in neurocritical care through responsible AI implementation.
Special Topic and Curated Session
Science of Neurocritical Care
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionThis talk will review best practices for addressing sex/gender, race/ethnicity, and other considerations for reporting on marginalized populations in clinical research.
Breakout Session
Delivery, Quality and Safety
APP Practice
Diversity, Equity, and Inclusion
Global Neurocritical Care
Informatics
Patient Education
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionIncreasingly, clinicians will be faced with whether to adopt an artificial intelligence (AI) or machine learning (ML) tool in routine neurocritical care practice. While AI/ML tools hold immense potential, trustworthiness is a primary concern. This concern is magnified when caring for critically ill patients who are vulnerable. Trust extends beyond mere functionality; it encompasses alignment with ethical considerations, transparency, and avoiding destructive biases.
This session – targeted at providers, nurses, pharmacists – translates technical criteria into an approachable checklist for evaluating the trustworthiness of an AI/ML tool. Focusing on neurocritical care scenarios, we will first review 1) robustness, 2) interpretability, 3) fairness, and 4) evaluation metrics. Taking a deeper step into interpretability, we discuss cutting-edge approaches to improve explainability.
Robustness is consistent performance, including unseen scenarios. Interpretability is being able to relate the result to an explainable rationale. Fairness is quantifying and avoiding bias, both human and algorithmic. Evaluation techniques are approaches to learn how a tool performs for both common scenarios and outliers. We then discuss more innovative approaches that enable “counterfactual” reasoning to answer the “why” question and that provide “attribution” approaches by quantifying the “importance” of features.
This will establish a roadmap for both technical and non-technical audiences, guiding them through the step-by-step assessment of AI/ML tools when reading the literature, discussing clinical implementation, and educating patients and colleagues. By promoting ethical, trustworthy, and transparent use of AI/ML tools, clinicians will be empowered to enhance outcomes while setting realistic boundaries regarding that tool’s limitations.
This session – targeted at providers, nurses, pharmacists – translates technical criteria into an approachable checklist for evaluating the trustworthiness of an AI/ML tool. Focusing on neurocritical care scenarios, we will first review 1) robustness, 2) interpretability, 3) fairness, and 4) evaluation metrics. Taking a deeper step into interpretability, we discuss cutting-edge approaches to improve explainability.
Robustness is consistent performance, including unseen scenarios. Interpretability is being able to relate the result to an explainable rationale. Fairness is quantifying and avoiding bias, both human and algorithmic. Evaluation techniques are approaches to learn how a tool performs for both common scenarios and outliers. We then discuss more innovative approaches that enable “counterfactual” reasoning to answer the “why” question and that provide “attribution” approaches by quantifying the “importance” of features.
This will establish a roadmap for both technical and non-technical audiences, guiding them through the step-by-step assessment of AI/ML tools when reading the literature, discussing clinical implementation, and educating patients and colleagues. By promoting ethical, trustworthy, and transparent use of AI/ML tools, clinicians will be empowered to enhance outcomes while setting realistic boundaries regarding that tool’s limitations.
Special Topic and Curated Session
Clinical Practice
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionAPPs make up a significant proportion of the Neurocritical Care Society, yet not a large proportion of the prestigious Fellow of the Neurocritical Care Society recognition. This session will demonstrate how APPs can highlight excellence in their daily work to demonstrate the four FNCS focus areas: dedicated program development, scholarship, leadership and professionalism/collaboration within the field of neurocritical care. Real examples from FNCS-designated APPs will be highlighted and will include examples of APP engagement beyond the APP’s home organization. This talk is part of a three-part series, with the first talk being on general FNCS requirements and a second talk focused on pharmacists' experience with FNCS .
Breakout Session
Science of Neurocritical Care
General Critical Care
Global Neurocritical Care
Informatics
Multimodal Neuromonitoring (invasive/non-invasive)
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
DescriptionIn the last decade, artificial intelligence (AI) and machine learning (ML) have emerged as powerful tools capable of augmenting our understanding of acute and devastating neurological disorders. For example, in the management of stroke care, penumbra mapping using advanced AI based software has extended the window of intervention 6 hours to beyond 24 hours. This has shown drastic improvements in the outcomes of this once devastating neurological injury.
However, the promise of AI is not limited to stroke care only. Machine learning algorithms, trained on vast datasets, excel at detecting anomalies in neuroimaging and neurophysiologic studies, such as EEG, relative to the traditional approach of observing with the naked eye and can correlate this information with or simply analyze clinical data with very high fidelity. This essentially allows researchers and clinicians to visualize and interpret patient data in an unparalleled manner and has the potential to yield valuable information to assist in managing some of the deadliest and most disabling conditions where treatment decisions are often under time pressure, hopefully leading to earlier detection of diseases, more timely interventions, improved patient outcomes, and better understanding of patient prognosis.
In this session, we will discuss the role of subarachnoid volumetrics in predictive modeling of Subarachnoid hemorrhage in terms of outcome, mortality and complications including delayed cerebral ischemia, and development of an automated model harnessing artificial intelligence for rapid detection, triage and predictive modeling for these patients.
However, the promise of AI is not limited to stroke care only. Machine learning algorithms, trained on vast datasets, excel at detecting anomalies in neuroimaging and neurophysiologic studies, such as EEG, relative to the traditional approach of observing with the naked eye and can correlate this information with or simply analyze clinical data with very high fidelity. This essentially allows researchers and clinicians to visualize and interpret patient data in an unparalleled manner and has the potential to yield valuable information to assist in managing some of the deadliest and most disabling conditions where treatment decisions are often under time pressure, hopefully leading to earlier detection of diseases, more timely interventions, improved patient outcomes, and better understanding of patient prognosis.
In this session, we will discuss the role of subarachnoid volumetrics in predictive modeling of Subarachnoid hemorrhage in terms of outcome, mortality and complications including delayed cerebral ischemia, and development of an automated model harnessing artificial intelligence for rapid detection, triage and predictive modeling for these patients.
Special Topic and Curated Session
Clinical Practice
Basic/Neurocritical Care 101
Intermediate
DescriptionThis will be a conversational style session with alternating opinion/experience sharing of the three discussants.
Abstract
Science of Neurocritical Care
Subarachnoid Hemorrhage
Intermediate
Special Topic and Curated Session
Clinical Practice
Traumatic Brain Injury
Intermediate
DescriptionGuidelines for brain injury management developed by the Brain Trauma Foundation significantly impact patient care. This talk is the first of a 4-part series focused on updated BTF guidelines for the management of penetrating traumatic brain injury (pTBI).
Breakout Session
Delivery, Quality and Safety
Diversity, Equity, and Inclusion
Global Neurocritical Care
Hospitalist Practice
Patient Education
Intermediate
Advanced
DescriptionIntroduction:
Critical health care disparities exist in South Asia, particularly, increased risk of ischemic and hemorrhagic stroke. Despite susceptibility to worse outcomes, there is a stark insufficiency in access to specialized neurocritical care services, acute stroke networks in countries like India. This session aims to shed light on existing disparities in health care and discuss potential solutions to enhance access to specialized neurocritical care and acute stroke services in South Asian countries, such as India.
Objectives:
Risk Factors and Outcomes: Analyzing the heightened risk of stroke among South Asians and their association with inferior clinical outcomes, emphasizing the urgency for specialized care.
Access Disparities: Investigating barriers leading to limited access to neurocritical care services, acute stroke networks, and advanced interventions like thrombectomy and minimally invasive surgery in South Asian countries.
Global Disparities vs. Local Realities: Distinguishing between global and region-specific factors contributing to healthcare disparities, providing a nuanced understanding of the unique challenges faced by South Asian nations, such as India.
Solutions and Collaborations: Proposing actionable solutions, exploring potential collaborations, and advocating for policies that can bridge the existing gaps in neurocritical care services and acute stroke management in South Asia.
Conclusion:
This talk invites healthcare professionals to engage in a crucial conversation about the disparities in neurocritical care services and acute stroke management faced by South Asians. By raising awareness and discussing practical solutions, we aim to catalyze efforts towards creating an equitable healthcare landscape in the region, ultimately improving outcomes for individuals at risk of critical neurological diseases.
Critical health care disparities exist in South Asia, particularly, increased risk of ischemic and hemorrhagic stroke. Despite susceptibility to worse outcomes, there is a stark insufficiency in access to specialized neurocritical care services, acute stroke networks in countries like India. This session aims to shed light on existing disparities in health care and discuss potential solutions to enhance access to specialized neurocritical care and acute stroke services in South Asian countries, such as India.
Objectives:
Risk Factors and Outcomes: Analyzing the heightened risk of stroke among South Asians and their association with inferior clinical outcomes, emphasizing the urgency for specialized care.
Access Disparities: Investigating barriers leading to limited access to neurocritical care services, acute stroke networks, and advanced interventions like thrombectomy and minimally invasive surgery in South Asian countries.
Global Disparities vs. Local Realities: Distinguishing between global and region-specific factors contributing to healthcare disparities, providing a nuanced understanding of the unique challenges faced by South Asian nations, such as India.
Solutions and Collaborations: Proposing actionable solutions, exploring potential collaborations, and advocating for policies that can bridge the existing gaps in neurocritical care services and acute stroke management in South Asia.
Conclusion:
This talk invites healthcare professionals to engage in a crucial conversation about the disparities in neurocritical care services and acute stroke management faced by South Asians. By raising awareness and discussing practical solutions, we aim to catalyze efforts towards creating an equitable healthcare landscape in the region, ultimately improving outcomes for individuals at risk of critical neurological diseases.
General Session
DescriptionDr. Claassen will share recent updates on the epidemiology of covert consciousness from a large multicenter study and talk about the challenges and opportunities of implementing this technique at the bedside. I will specifically highlight confounders frequently encountered in the ICU including sedation and aphasia for the diagnosis of covert consciousness.
Breakout Session
Science of Neurocritical Care
Bedside Nursing
Coma
Diversity, Equity, and Inclusion
Global Neurocritical Care
Introductory
Intermediate
DescriptionCOMPOSE is a prospective observational study funded by the Neurocritical Care Foundation. The objectives of the study are to a) define the natural history of coma recovery in patients with acute neurological injury, b) to set up a hub and spoke coma research network and c) to explore variability in care and the factors affecting coma recovery. Thirty-one sites from 14 countries spanning 5 continents are participating in this study and are currently enrolling patients who experience coma within 72 hours of neurological injury and have persistent coma for at least 3 days. The neurological outcomes are evaluated using the disability rating scale, GCS as well as the extended Glasgow outcomes scale (GOS-E). In this session, two speakers will share insights over a 10-minute interval, delineating the trial's design, demographics, geographical dispersion, etiology of coma, diagnostic modalities, and the influence of life-sustaining treatment withdrawal on the phenotypic recovery within our patient cohort. We will also discuss the exploration of the factors shaping phenotypic recovery. This segment underscores the study's commitment to unraveling the complexities of coma recovery on a global scale, fostering collaboration, and advancing patient care paradigms worldwide.
Special Topic and Curated Session
Science of Neurocritical Care
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionDr. Shraddha Mainali (VCU) will discuss how to approach peer review in a constructive manner, and highlight ways to support the authors in improving the science, writing, framework, and analysis.
General Session
DescriptionOver the two past decades, clinicians have encountered patients who, despite showing no behavioral signs of consciousness at the bedside, respond to active neuroimaging or electrophysiological paradigms. This phenomenon, reported extensively in the literature, is observed in around 20% of patients whose behavioral assessments suggested VS/UWS. Consequently, the American and European Academy of Neurology started to advise using neuroimaging and electrophysiology for the diagnosis of patients with disorders of consciousness (DoCs). Despite recognition of this phenomenon, consensus on its nomenclature is lacking, with various terms used interchangeably. A recent Delphi study assessed expert agreement on taxonomy. The findings will be presented. Future discussions on taxonomy are warranted to better define this entity and start developing treatment.
Abstract
Science of Neurocritical Care
Medical Issues, Pharmacology, and Coagulopathy
Intermediate
Breakout Session
Clinical Practice
APP Practice
Bedside Nursing
Delirium
General Critical Care
Multimodal Neuromonitoring (invasive/non-invasive)
Neurogenic Respiratory Failure
Intermediate
DescriptionDelirium is a condition that occurs commonly among critically ill stroke patients. Those who experience an episode of delirium have worse outcomes than their non-delirious counterparts. Accurate, reliable, and easily applicable delirium screening tools are required to address this complication. Until recently, minimal attention has been given to measuring delirium among critically ill stroke and neurocritical care patients. The Fluctuating Mental Status Evaluation (FMSE) has been developed specifically for patients with neurologic injury. Other more widely used tools such as the Confusion Assessment Method for the ICU (CAM-ICU), 4AT, and Intensive Care Delirium Screening Checklist (ICDSC) have mixed evidence for their use in a neurocritical care population. This talk will discuss the psychometrics of delirium screening tools considering DSM-V or ICD-10 criteria. The interplay between delirium and coma, sedation, and aphasia are important considerations for clinicians and researchers to incorporate into their practice. This talk will enable participants to be able to discuss special considerations for measurement of delirium among patients with acute neurologic injury.
Abstract
General Session
Pediatric
Breakout Session
Delivery, Quality and Safety
Basic/Neurocritical Care 101
Coma
General Critical Care
Global Neurocritical Care
Traumatic Brain Injury
Introductory
DescriptionDisease-specific registries have emerged as powerful tools that can drive quality improvement. These have proven feasible and effective in improving care delivery and patient outcomes in neurocritical care-relevant disease conditions, but quality improvement registries specific to neurocritical care with a dedicated focus on neurocritical care disease conditions remain in the early stages of development. There exists significant opportunity both nationwide and globally for a collaborative cross-institutional approach to improving patient outcomes through neurocritical care-specific registries.
This presentation will focus on current quality improvement registry development opportunities within neurocritical care. Discussion will include opportunities for collaboration with the Curing Coma Campaign as well as emerging intracerebral hemorrhage registries. We will also explore the pragmatic aspects of data collection, benchmarking and identification of outlier high performing institutions to promote shared learning and identification of best practices.
This presentation will focus on current quality improvement registry development opportunities within neurocritical care. Discussion will include opportunities for collaboration with the Curing Coma Campaign as well as emerging intracerebral hemorrhage registries. We will also explore the pragmatic aspects of data collection, benchmarking and identification of outlier high performing institutions to promote shared learning and identification of best practices.
Breakout Session
Clinical Practice
Basic/Neurocritical Care 101
Coma
General Critical Care
Hospitalist Practice
NCC Fellowship/Training
Advanced
DescriptionNeurointensivists are often asked to assist with brain death testing of patients on extracorporeal membrane support (ECMO). This talk focus on the practical and logistical aspects of performing brain death testing in this unique patient population.
Special Topic and Curated Session
Clinical Practice
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionThe purpose of this session is to provide feedback and guidance for members who are interested in career development in the four core domains required for FNCS designation - program development, scholarly activities, leadership, and professionalism/collaboration. FNCS designation is available to all NCS members ( physicians, APP's, Pharmacists, Nurses and others) in both academic and non-academic settings. Guidance in navigating the application process including minimum requirements as well as a review of the sustained excellence that the committee is looking for in the four requisite domains will be discussed.
Breakout Session
Delivery, Quality and Safety
Bedside Nursing
Global Neurocritical Care
NCC Fellowship/Training
Pediatric
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
Intermediate
DescriptionThis session is focused on promoting PNCC global health education and research initiatives to develop a PNCC simulation-based curriculum in partnership with multidisciplinary healthcare professionals in resource-limited settings. Our speakers consist of multidisciplinary experts specializing in PNCC and simulation. The aim is that this session will educate participants on the development and impact of these global health initiatives to provide outstanding pediatric neurocritical care for all children worldwide- globally ‘making waves’ in PNCC through simulation education and innovation.
Proposal will be 90 min seminar with six speakers divided in 3 talks ~20 min each and 20-30 min of Q &A/ panelist discussion. Speakers are diverse in discipline, career stage, institutions, gender, demographics.
Speakers:
Renad Abu-Sawwa, PharmD, BCPPS
Jennifer Munoz Pareja, MD
Nicolas Chiriboga Salazar, MD
Ericka Fink, MD, MS
Nichole O’Brian, MD
Andrea C. Pardo, MD
Proposal will be 90 min seminar with six speakers divided in 3 talks ~20 min each and 20-30 min of Q &A/ panelist discussion. Speakers are diverse in discipline, career stage, institutions, gender, demographics.
Speakers:
Renad Abu-Sawwa, PharmD, BCPPS
Jennifer Munoz Pareja, MD
Nicolas Chiriboga Salazar, MD
Ericka Fink, MD, MS
Nichole O’Brian, MD
Andrea C. Pardo, MD
Breakout Session
Science of Neurocritical Care
Coma
Status Epilepticus
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Advanced
DescriptionPost-traumatic epilepsy is an important early and sometimes late complication of traumatic brain injury. The onset, temporal evolution and risk factors for post-traumatic epilepsy are important features of neurocritical care and influence ICU management as well as the Post-ICU management.
Late-Breaking Abstract
Science of Neurocritical Care
Head and Spine Trauma
Seizures/EEG
Curing Coma
Intermediate
Breakout Session
Delivery, Quality and Safety
Basic/Neurocritical Care 101
Coma
General Critical Care
Global Neurocritical Care
Traumatic Brain Injury
Introductory
DescriptionIn the realm of neurocritical care, ensuring the accuracy and usefulness of registry measures is paramount for improving patient outcomes and advancing medical knowledge. This talk delves into the critical process of testing measures for reliability, validity, and feasibility within neurocritical care registries. Participants will gain an understanding of how these testing processes underpin the quality and reliability of data collected, thus enhancing the effectiveness of quality improvement initiatives and research endeavors. Through exploring methods such as inter-rater reliability assessments, criterion validity comparisons, and feasibility pilot studies, attendees will identify practical approaches to evaluate the robustness of neurocritical care measures. Moreover, the session will elucidate the significance of integrating reliability, validity, and feasibility testing into the development and implementation phases of registry measures, empowering healthcare professionals to optimize data collection practices. Ultimately, this talk aims to equip participants with the knowledge and tools necessary to ensure that neurocritical care registry measures are not only accurate and reliable but also feasible to implement in real-world clinical settings, thereby driving continual improvement in neurocritical care delivery.
Breakout Session
Delivery, Quality and Safety
Diversity, Equity, and Inclusion
Global Neurocritical Care
Hospitalist Practice
Patient Education
Advanced
DescriptionThis presentation delves into the epidemiology and clinical management of ventriculitis within the unique context of a middle-income country, with a specific focus on insights gleaned from Brazil's healthcare system. Ventriculitis, a serious complication characterized by inflammation of the cerebral ventricles, poses significant challenges in resource-limited settings due to constrained healthcare resources and infrastructure. Drawing from extensive experience and data from Brazil, the talk explores the prevalence, risk factors, diagnostic approaches, and treatment modalities for ventriculitis in such environments. Attendees will gain valuable insights into the epidemiological trends, common pathogens, therapeutic strategies, and outcomes associated with ventriculitis, as well as practical considerations and adaptations necessary for effective management in middle-income countries. Through case studies and evidence-based recommendations, the presentation aims to equip healthcare professionals with the knowledge and tools needed to improve the diagnosis and management of ventriculitis in similar resource-constrained settings.
Breakout Session
Delivery, Quality and Safety
APP Practice
Bedside Nursing
Diversity, Equity, and Inclusion
Global Neurocritical Care
Hospitalist Practice
Patient Education
Introductory
Intermediate
DescriptionProvide an overview of existing literature on racism in healthcare, emphasizing studies that highlight its prevalence and impact on patient outcomes. Include evidence supporting the need for addressing racism in the ICU setting and the potential benefits of a comprehensive approach to mitigate these issues.
Special Topic and Curated Session
Clinical Practice
Traumatic Brain Injury
Intermediate
DescriptionIn the third talk of this 4-part series, key recommendations from the updated pTBI guidelines will be discussed. This will be the first presentation of the guideline expected to be published in close proximity to the NCS meeting.
Breakout Session
Delivery, Quality and Safety
APP Practice
Bedside Nursing
Diversity, Equity, and Inclusion
Global Neurocritical Care
Hospitalist Practice
Patient Education
Introductory
Intermediate
DescriptionTo close the gap in health literacy, patients must understand the specific role of the patient. This is not intuitive and requires education. As clinicians, we are great at teaching patients about their disease process and what they should or should not do once discharged—however, education about taking an active role as a patient is lacking. Health disparities and social determinants of health are impacted by the level of education a person has. This includes academics, health education, and knowledge about the healthcare system itself. Shared decision-making is ineffective if the patient is not active in their care. To be an active participant, patients must understand what it means to be a patient. Healthcare clinicians view patients through a specific lens, including the person and what they represent as a medical case. The total picture includes medical conditions, medications, allergies, diet, and social factors- we put these factors together while managing the acute or chronic disease at hand. Patients must understand this view and how their contribution impacts their health. To fight health inequity, cut utilization costs, improve health outcomes, and give power back to the patient, patients must have an active presence in who they are as patients. This education point can be tackled by bedside nursing, advanced practice clinicians, and physicians, whether outpatient or inpatient. Technology utilization in the form of smartphone applications can optimize patients' understanding of how to increase their involvement in their health care.
Breakout Session
Clinical Practice
Coma
Multimodal Neuromonitoring (invasive/non-invasive)
Pediatric
Provider Education Topics (eg fellowship training, competency assessment, etc)
Status Epilepticus
Introductory
Intermediate
DescriptionNeuroprognostication in neonates with acute brain injury has historically and is currently largely guided largely by expert opinion. However, a growing body of research evaluating multiple modalities of brain injury associated with outcomes is aggregating. In this presentation we will present the current major professional society recommendation for neuroprognostication in neonates, and provide a new systematic review of the literature, evaluating the higher GRADE levels of evidence linking modern tests of brain injury to outcomes in neonates. We will also distinguish between studies following GRADE recommendations including prospective vs retrospective, controlled vs non-controlled, the timing of test and outcome measure acquisition, and tracking of reduction of subjects by reasons including mortality and loss to follow-up.
Breakout Session
Clinical Practice
Coma
General Critical Care
Global Neurocritical Care
Hospitalist Practice
Multimodal Neuromonitoring (invasive/non-invasive)
Nerve and Muscle Disease
Nursing Pharmacology
Intermediate
Advanced
DescriptionPatients suffering from acute brain insult exhibit a great risk of secondary brain injury. Brain metabolic monitoring provides insight into brain pathophysiologic state. Diagnostic approaches include imaging and other continuous monitoring techniques such as cerebral microdialysis. Integrating brain metabolic monitoring in the current management concept may help to stratify individual treatment strategies in different disease states.
This talk will summarize brain metabolic monitoring techniques and provide strategies for implementing tailored interventions targeting brain metabolic distress, ischemia and hyperglycolysis. These concepts will include hemodynamic interventions, nutritional aspects and targeted glucose management strategies. This talk will supplement the submitted proposal on “Medical nutritional therapy in neurocritical care – from assessment to intervention”.
This talk will summarize brain metabolic monitoring techniques and provide strategies for implementing tailored interventions targeting brain metabolic distress, ischemia and hyperglycolysis. These concepts will include hemodynamic interventions, nutritional aspects and targeted glucose management strategies. This talk will supplement the submitted proposal on “Medical nutritional therapy in neurocritical care – from assessment to intervention”.
Special Topic and Curated Session
Clinical Practice
Basic/Neurocritical Care 101
Intermediate
DescriptionThis will be a conversational style session with alternating opinion/experience sharing of the three discussants.
Ancillary Meeting
Clinical Practice
Bedside Nursing
Informatics
Introductory
DescriptionTherapeutic humour is defined to be any intervention that promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity or incongruity of life's situations. This intervention may enhance health or be used as a complementary treatment of illness to facilitate healing or coping, whether physical, emotional, cognitive, social or psychological
Humour can be used in all kinds of ways or situations, to relativize, make tense situations less tense or it can be used to make life more pleasant. If a nurse uses humour as an intervention in complimentary care, certain patients may complain less. This presentation will look at Humour as a nursing intervention. The listener will be taken on a journey and examples of what humour is and how humour can be used in different situations.
At the end of the presentation the listener will be able to see that humour can be a tool to be used as a nursing intervention, but the listener will have to make up his or her mind and decide if he or she can use it.
Key words: humour, nursing intervention, cheerfulness, expressions.
Humour can be used in all kinds of ways or situations, to relativize, make tense situations less tense or it can be used to make life more pleasant. If a nurse uses humour as an intervention in complimentary care, certain patients may complain less. This presentation will look at Humour as a nursing intervention. The listener will be taken on a journey and examples of what humour is and how humour can be used in different situations.
At the end of the presentation the listener will be able to see that humour can be a tool to be used as a nursing intervention, but the listener will have to make up his or her mind and decide if he or she can use it.
Key words: humour, nursing intervention, cheerfulness, expressions.
Breakout Session
Delivery, Quality and Safety
APP Practice
NCC Fellowship/Training
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionEntrustable professional activities (EPAs), which are tasks or responsibilities to be entrusted to an individual who has attained sufficient, specific competence, have been proposed as a useful concept in both neurology education and advanced practice provider (APP) post-graduate training. Unique neurocritical care EPAs have recently been developed for neurology resident neurocritical care education in Germany as well as for APPs who are new to neurocritical care practice in the United States. Now that these EPAs have been defined, what’s next?
This session will first provide an overview of why leaders and educators in neurocritical care might consider implementing EPAs for providers at their institutions. The presentation will describe the potential benefits of applying the EPA framework for structuring neurocritical care training curricula (with a focus on APP onboarding) and advantages of EPA-based assessments, which are simple to construct and interpret. This session will then turn to offering practical tips for implementing EPA-based curricula and assessments. By the end of the session, participants will have the tools to begin to develop these curricula and assessments for providers at their institutions.
This session will first provide an overview of why leaders and educators in neurocritical care might consider implementing EPAs for providers at their institutions. The presentation will describe the potential benefits of applying the EPA framework for structuring neurocritical care training curricula (with a focus on APP onboarding) and advantages of EPA-based assessments, which are simple to construct and interpret. This session will then turn to offering practical tips for implementing EPA-based curricula and assessments. By the end of the session, participants will have the tools to begin to develop these curricula and assessments for providers at their institutions.
Abstract
General Session
DescriptionShereen Thor is a Keynote speaker on a mission to create a more equitable world through all of her work. Join us for her keynote speech entitled Breaking Barriers, Saving Lives to help create a more inclusive and Equitable Future in Neurocritical care.
Breakout Session
Science of Neurocritical Care
Informatics
Nursing Pharmacology
Traumatic Brain Injury
Advanced
DescriptionSignificant scientific progress in the past two decades has deepened our comprehension of the intricate and diverse pathophysiological mechanisms linked with traumatic brain injury (TBI). Concurrently, numerous experimental therapeutics have exhibited neuroprotective properties in preclinical studies. Regrettably, none of these approaches have demonstrated efficacy in clinical trials for TBI. The failure of clinical therapy trials is often attributed to TBI's heterogeneity, the oversimplified TBI classifications, the lack of biomarkers for therapeutic intervention monitoring, and the limited translatability of preclinical TBI models.
Recognized now is the multifaceted nature of TBI pathophysiology, which involves acute, progressive, and chronic neurodegenerative processes, comprising intricate cascades of biological events at cellular and molecular levels. Corresponding to the diverse pathophysiologic processes in TBI, a range of TBI biofluid-based protein biomarkers and endophenotypes have been identified. These biomarkers encompass axonal injury, dendritic injury, neuronal injury, demyelination, synaptic injury, astroglia injury, and microglia responses. Other plausible links between TBI and long-term outcomes include a combination of: alterations in neurobiological mechanisms and the emergence of other medical comorbidities after injury; and subsequent behavioral and lifestyle changes that put patients at higher risk of poor outcomes.
This talk will provide an update on the current understanding of TBI biofluid-based protein biomarkers, and other emerging post-TBI long-term medical comorbidities and endophenotypes. It will also delve into biomarker evidence in TBI diagnosis, outcome prognosis, and their role as theranostics tools.
Recognized now is the multifaceted nature of TBI pathophysiology, which involves acute, progressive, and chronic neurodegenerative processes, comprising intricate cascades of biological events at cellular and molecular levels. Corresponding to the diverse pathophysiologic processes in TBI, a range of TBI biofluid-based protein biomarkers and endophenotypes have been identified. These biomarkers encompass axonal injury, dendritic injury, neuronal injury, demyelination, synaptic injury, astroglia injury, and microglia responses. Other plausible links between TBI and long-term outcomes include a combination of: alterations in neurobiological mechanisms and the emergence of other medical comorbidities after injury; and subsequent behavioral and lifestyle changes that put patients at higher risk of poor outcomes.
This talk will provide an update on the current understanding of TBI biofluid-based protein biomarkers, and other emerging post-TBI long-term medical comorbidities and endophenotypes. It will also delve into biomarker evidence in TBI diagnosis, outcome prognosis, and their role as theranostics tools.
Workshop
Stroke
Introductory
DescriptionWe are thrilled to announce an exciting partnership between the Neurocritical Care Society (NCS) and Sharp HealthCare for an upcoming workshop in San Diego. Immerse yourself in the world of neuroanatomy at Sharp Prebys’ state-of-the-art Innovation and Education Center in San Diego. This Interactive 3D Neuroanatomy Workshop is designed to keep you engaged and excited throughout. Under the guidance of esteemed clinicians Linda Littlejohns MSN, RN, FAAN, and DaiWai Olson PhD, RN, FNCS, this workshop promises a dynamic exploration of the brain’s intricate structures and vasculature. Their expertise and experience ensure that attendees gain valuable insights into common neurocritical care conditions such as stroke, trauma, and acute pathologies through interactive 3D tools, case studies, dual screens, a coloring book, and live demonstrations.
Aligning with the educator of choice strategic goal, NCS is excited to unite healthcare professionals and provide essential education to elevate knowledge and enhance patient outcomes for those facing life-threatening neurological illnesses.
Transportation for attendees will be provided by Sharp.
Aligning with the educator of choice strategic goal, NCS is excited to unite healthcare professionals and provide essential education to elevate knowledge and enhance patient outcomes for those facing life-threatening neurological illnesses.
Transportation for attendees will be provided by Sharp.
Breakout Session
Science of Neurocritical Care
Bedside Nursing
Coma
Diversity, Equity, and Inclusion
Global Neurocritical Care
Intermediate
DescriptionThis session will explore the international variability in the assessment and management of disorders of consciousness (DoC) and prediction of recovery. The identification, evaluation, intervention, exploration, prognostication and limitation of therapy for patients with DoC will be reviewed through an international lens. The myriad factors that impact the diagnosis and management of DoC including 1) financial, 2) legal and regulatory, 3) cultural, 4) religious and 5) psychosocial considerations will be discussed. As data comparing patients with DoC internationally are limited, findings from the general critical care or neurocritical care literature will be described when information specific to patients with DoC is unavailable.
There is a need for improvements in clinical care, education, advocacy and research related to patients with DoC worldwide. It is imperative to standardize methodology to evaluate consciousness and prognosticate outcome. Further, education is needed to 1) generate awareness of the impact of the aforementioned considerations on patients with DoC and 2) develop techniques to optimize communication about DoC with families. It is necessary to promote equity in access to expertise and resources for patients with DoC to enhance the care of patients with DoC worldwide. Improving understanding and management of patients with DoC requires harmonization of existing datasets, development of registries where none exist and establishment of international clinical trial networks that include patients in all phases along the spectrum of care. The work of international organizations like the Curing Coma Campaign can hopefully minimize international variability in the diagnosis and management of DoC and optimize care.
There is a need for improvements in clinical care, education, advocacy and research related to patients with DoC worldwide. It is imperative to standardize methodology to evaluate consciousness and prognosticate outcome. Further, education is needed to 1) generate awareness of the impact of the aforementioned considerations on patients with DoC and 2) develop techniques to optimize communication about DoC with families. It is necessary to promote equity in access to expertise and resources for patients with DoC to enhance the care of patients with DoC worldwide. Improving understanding and management of patients with DoC requires harmonization of existing datasets, development of registries where none exist and establishment of international clinical trial networks that include patients in all phases along the spectrum of care. The work of international organizations like the Curing Coma Campaign can hopefully minimize international variability in the diagnosis and management of DoC and optimize care.
Breakout Session
Science of Neurocritical Care
Coma
Status Epilepticus
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
Advanced
DescriptionDevelopment and advancement in neurocritical care have resulted in increased survival of subarachnoid hemorrhage (SAH) patients, resulting in increased morbidity that has a socioeconomic impact at individual and societal levels. The young SAH survivors have long-term cognitive disability. How much of this is from the event itself, how much of this is from the lingering effects of the type of treatment received, and how much of it is related to the late effects of this event is currently unknown. The proposed talk would summarize the role of extravasated subarachnoid blood products in secondary brain injury and discuss how genetic predisposition (e.g., haptoglobin genotype) may predispose some-more compared to others and whether mere mechanical removal of this extravasated blood is enough in decreasing patient morbidity. Additionally, systemic procoagulant and proinflammatory responses will be briefly discussed to highlight the role of intravascular blood, the interplay between these two processes in exacerbating secondary brain injury, and how these can be modulated to decrease patient morbidity and improve cognitive outcomes.
Breakout Session
Science of Neurocritical Care
Coma
Status Epilepticus
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
Advanced
DescriptionThe increased risk of neurological and psychiatric conditions after traumatic brain injury (TBI) is well-defined. However, the risk of cardiovascular and endocrine comorbidities after TBI in individuals without these comorbidities and their association with post-TBI mortality has received little attention. In this talk, I will present data suggesting that TBI of any severity is associated with a higher incidence of chronic cardiovascular comorbidities in patients without baseline diagnoses. The risk of post-TBI comorbidities is relatively higher in all age groups compared with age-matched controls, and notably so in patients younger than 40. Comorbidities arising after TBI were associated with increased mortality. Our published work in Lancet Neurology (Izzy et al. Oct 2023, PMID 37739576) suggests that the residual effects of TBI are not static once initial recovery has plateaued. This talk will highlight the need for a proactive targeted screening program for multisystem diseases following TBI, particularly chronic cardiometabolic diseases.
Breakout Session
Science of Neurocritical Care
General Critical Care
Global Neurocritical Care
Informatics
Multimodal Neuromonitoring (invasive/non-invasive)
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
DescriptionIn recent years, the potential of computerized machine learning (ML) processes has been widely explored in clinical research, with promising results. Regarding acute brain injured (ABI) patients, the establishment of extensive databases from the collection of diverse biometric markers using various neuromonitoring techniques has enabled the advancement of ML models, transforming their diagnostic approach.
The present session is dedicated to present and discuss ML applications in neuro-ICU, in the point-of-view of three clinicians involved with model development, research and translation to clinical practice.
Lecture 1- Noninvasive estimation of intracranial pressure (ICP); A large dataset of ICP recording was collected from 146 ABI patients using both invasive (external ventricular drains) and noninvasive systems concomitantly. The noninvasive system is based on skull micro-expansions, registering surrogate ICP pulse morphology. The ML model developed allowed estimating ICP values from noninvasive pulse slopes accurately, providing a pioneer means of ICP monitoring exempt of additional risks for patients.
Lecture 2- Early detection of elevated risk for ischemia after spontaneous subarachnoid hemorrhage (SAH); A ML model was created to predict delayed cerebral ischemia (DCI) in 399 spontaneous SAH patients by means of a comprehensive eletronic medical record including radiological, laboratorial and clinical data. The model was succesful to predict DCI as well as discharge and 3-month outcomes, with potential to improve SAH management.
Lecture 3- A ML approach combining information from transcranial Doppler, arterial blood pressure and electrocardiogram was built to indicate ideal cerebral perfusion pressure in ABI patients, leveling cerebral hemodynamic autoregulation failure in this population.
The present session is dedicated to present and discuss ML applications in neuro-ICU, in the point-of-view of three clinicians involved with model development, research and translation to clinical practice.
Lecture 1- Noninvasive estimation of intracranial pressure (ICP); A large dataset of ICP recording was collected from 146 ABI patients using both invasive (external ventricular drains) and noninvasive systems concomitantly. The noninvasive system is based on skull micro-expansions, registering surrogate ICP pulse morphology. The ML model developed allowed estimating ICP values from noninvasive pulse slopes accurately, providing a pioneer means of ICP monitoring exempt of additional risks for patients.
Lecture 2- Early detection of elevated risk for ischemia after spontaneous subarachnoid hemorrhage (SAH); A ML model was created to predict delayed cerebral ischemia (DCI) in 399 spontaneous SAH patients by means of a comprehensive eletronic medical record including radiological, laboratorial and clinical data. The model was succesful to predict DCI as well as discharge and 3-month outcomes, with potential to improve SAH management.
Lecture 3- A ML approach combining information from transcranial Doppler, arterial blood pressure and electrocardiogram was built to indicate ideal cerebral perfusion pressure in ABI patients, leveling cerebral hemodynamic autoregulation failure in this population.
Breakout Session
Clinical Practice
Global Neurocritical Care
Ischemic Stroke
Multimodal Neuromonitoring (invasive/non-invasive)
Nursing Pharmacology
Status Epilepticus
Stroke
Traumatic Brain Injury
Intermediate
DescriptionSevere traumatic brain (sTBI) injury is a growing concern globally, particularly in low- and middle-income countries where outcomes tend to be poorer compared to high-income countries. While there are global initiatives aimed at addressing the surgical burden of this condition, much of the clinical knowledge and evidence stems from well-resourced areas. Nonetheless, disparities in sTBI management also exist in high-income countries, particularly in rural areas where multimodality monitoring, an expensive practice, is limited. In this presentation, we will delve into our experiences and advancements in managing sTBI patients, with a focus on recommending improvements in organizational structures, infrastructure, and personnel training and education to optimize patient care.
Breakout Session
Clinical Practice
Coma
General Critical Care
Global Neurocritical Care
Hospitalist Practice
Multimodal Neuromonitoring (invasive/non-invasive)
Nerve and Muscle Disease
Nursing Pharmacology
Intermediate
Advanced
DescriptionPatients suffering from acute brain injury exhibit great metabolic vulnerability due to commonly observed factors such as pre-existing malnutrition, disorders of consciousness, dysphagia, and the effects of prolonged sedation. This necessitates the implementation of specialized medical nutritional therapy, as both insufficient and excessive nutrition can lead to adverse outcomes. Given the significant variability in metabolic demands among individuals and across different stages of illness, a tailored approach to nutritional support is paramount.
This talk will highlight the key concepts of nutrition therapy in the neurointensive care unit and its impact on established outcome-relevant endpoints such as blood sugar (variability) and ICU-acquired weakness. The presentation will explore the challenges of assessing nutritional needs and the strategies for implementing tailored nutritional interventions in a multidisciplinary team. It will also address the timing of nutrition therapy initiation and the adjustment of nutrition therapy based on biomarkers and indirect calorimetry.
This talk will highlight the key concepts of nutrition therapy in the neurointensive care unit and its impact on established outcome-relevant endpoints such as blood sugar (variability) and ICU-acquired weakness. The presentation will explore the challenges of assessing nutritional needs and the strategies for implementing tailored nutritional interventions in a multidisciplinary team. It will also address the timing of nutrition therapy initiation and the adjustment of nutrition therapy based on biomarkers and indirect calorimetry.
Breakout Session
Clinical Practice
Coma
General Critical Care
Global Neurocritical Care
Hospitalist Practice
Multimodal Neuromonitoring (invasive/non-invasive)
Nerve and Muscle Disease
Nursing Pharmacology
Intermediate
Advanced
DescriptionPatients suffering from acute brain injury exhibit great metabolic vulnerability. Factors such as endocrinologic and metabolic derangements due to primary insult, excessive flooding with stress hormones, multi-pharmacological ICU therapy, organ failure and altered nutritional regimens render the brain prone to different types of encephalopathy. The latter comprises a plethora of entities that is challenging to define and to grasp. Quite often, it is overlooked, diagnosed too late or neglected in neurocritical care.
This talk will highlight the key traditional concepts of metabolic encephalopathies encountered in the Neurocritical Care Unit and explore recent advances in the understanding of its pathophysiology, diagnostics and monitoring, clinical course, treatment, and outcome. Here, the current data situation will be blended with the educational aims of the talk. The presentation will explore the challenges of assessing and managing metabolic encephalopathy in the NCCU, including when it co-exists with other, more dominant acute brain injury. It will eventually suggest a standardized approach to metabolic encephalopathies via an SOP.
This talk will highlight the key traditional concepts of metabolic encephalopathies encountered in the Neurocritical Care Unit and explore recent advances in the understanding of its pathophysiology, diagnostics and monitoring, clinical course, treatment, and outcome. Here, the current data situation will be blended with the educational aims of the talk. The presentation will explore the challenges of assessing and managing metabolic encephalopathy in the NCCU, including when it co-exists with other, more dominant acute brain injury. It will eventually suggest a standardized approach to metabolic encephalopathies via an SOP.
Breakout Session
Science of Neurocritical Care
Basic/Neurocritical Care 101
General Critical Care
Intracerebral Hemorrhage
Multimodal Neuromonitoring (invasive/non-invasive)
Nursing Pharmacology
Pharmacist Practice
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
DescriptionNeurological and medical complications in neurocritical care contribute significantly to the overall disease prognosis. Pharmacological management plays a key role in managing complications such as cerebral vasospasm, delayed cerebral ischemia (DCI), hyponatremia, infections, and seizures. However, pathophysiologic changes induced the neurological illness make the medical management of these patients challenging. To illustrate, significant research efforts have been dedicated to understanding the mechanisms of DCI and investigating potential therapeutic modalities to enhance patient outcomes in subarachnoid hemorrhage patients. Several agents have been investigated to target DCI; however, none of those agents was proven effective with the exception of nimodipine. This has been attributed, at least in part, to the inter-individual variability in disease pathophysiology. Moreover, altered organ function, systemic inflammation, hemodynamic instability, and common interventions employed in intensive care settings have the ability to alter the pharmacokinetics and pharmacodynamics of medications. Neurocritical care patients endure numerous physiologic insults following a primary neurologic injury that can result in increased mortality, hospital length of stay and poor neurological outcomes. The use of potentially ineffective treatments and suboptimal dosing of medications to manage patients may inflate poor outcomes as the understanding of the influence of neurological injury on the action and disposition of drugs is ill defined.
The suggested session will provide an overview of the current research in this field, elucidate the factors that contribute to pharmacotherapy variability, and outline potential future research directions in this area.
The suggested session will provide an overview of the current research in this field, elucidate the factors that contribute to pharmacotherapy variability, and outline potential future research directions in this area.
Breakout Session
Science of Neurocritical Care
Basic/Neurocritical Care 101
General Critical Care
Intracerebral Hemorrhage
Multimodal Neuromonitoring (invasive/non-invasive)
Nursing Pharmacology
Pharmacist Practice
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
DescriptionThe goal of much clinical research (both trials and observational) is to estimate the relationship between one or more clinical characteristics or intervention with patients' outcomes. Unfortunately, we make these estimates from data contaminated by myriad treatment decisions. In randomized trials, these include post-randomization interventions that by definition cannot be balanced by us of prior randomization as an instrument. Risks of bias are even greater in observational studies. Traditional methods to make unbiased causal estimates (e.g., causal inference methods or randomization) cannot be used when an intervention is deterministic of outcome (e.g., withdrawal of life-sustaining therapies (WLST)). This creates a ubiquitous risk of self-fulfilling prophecies to which our neurocritically ill patients are uniquely vulnerable.
Supported by NINDS, we will present interim results from an R01 (R01NS124642) that aims to innovate novel methods that mitigate the risk of self-fulfilling prophecies by incorporating expert knowledge into prediction models. We reviewed >1,400 cases from comatose patients resuscitated from cardiac arrest who died after WLST with a pool of 35 international experts (3-5 experts per case, ~1,500 total expert-hours). Together with analytical colleagues, we developed multiple intuitive statistical approaches to infuse this expert knowledge into predictive models. We believe our work and results are of interest and broadly relevant to neurocritical care researchers and NCS conference-goers.
Supported by NINDS, we will present interim results from an R01 (R01NS124642) that aims to innovate novel methods that mitigate the risk of self-fulfilling prophecies by incorporating expert knowledge into prediction models. We reviewed >1,400 cases from comatose patients resuscitated from cardiac arrest who died after WLST with a pool of 35 international experts (3-5 experts per case, ~1,500 total expert-hours). Together with analytical colleagues, we developed multiple intuitive statistical approaches to infuse this expert knowledge into predictive models. We believe our work and results are of interest and broadly relevant to neurocritical care researchers and NCS conference-goers.
Breakout Session
Clinical Practice
Basic/Neurocritical Care 101
Coma
General Critical Care
Hospitalist Practice
NCC Fellowship/Training
Intermediate
Advanced
DescriptionThe skill of leading serious illness conversations (sometimes called “family meetings” or “goals of care conversations”) is most often taught using highly structured, often acronymic models that are easily standardized for use in multiple educational settings and levels of training. Despite increasingly robust education in this arena, studies in neurocritically ill patients and their surrogate decision-makers (SDMs) demonstrate difficulty achieving goal-concordant care persistent discordance in understanding of prognosis between the SDMs and medical team (e.g. Kiker et al, 2021). In this talk, I will address the importance of combining structured “acronymic” models of serious illness conversation with the concept of “narrative competence.” Narrative competence, first defined in 2001 by Dr. Rita Charon, is the ability to attend humanistically to the social, cultural, and personal context with which a patient or SDM approaches their illness. This talk will explore methods of assessing narrative competence in oneself and in learners. The talk will introduce attendees to techniques to improve their own narrative competence and integrate narrative techniques into serious illness conversations to facilitate more flexible, goal-concordant, and empathetic care.
Breakout Session
Clinical Practice
Intracerebral Hemorrhage
Ischemic Stroke
Multimodal Neuromonitoring (invasive/non-invasive)
Nursing Pharmacology
Pharmacist Practice
Stroke
Subarachnoid Hemorrhage
Intermediate
DescriptionIntroduction:
Blood pressure thresholds evolve through distinct phases of SAH care. Despite the fact that establishing specific blood pressure goals and induced hypertension after SAH are ubiquitous in clinical practice, there remains no evidence supporting this practice, and the latest American Heart Association and Neurocritical Care Society guidelines make no recommendations on specific blood pressure thresholds and make a cautious recommendation on induced hypertension. This talk will explore the supporting literature and pitfalls in the potential role of non-invasive and invasive neuromonitoring as tools for individualizing blood pressure goals and perfusion thresholds in SAH using cerebral autoregulation.
Session Objectives:
Dynamic Blood Pressure Goals: Unpacking the shifting targets in blood pressure management across SAH phases, emphasizing the need for personalized approaches before aneurysm securement, before and after delayed cerebral ischemia.
Current Gaps: Shedding light on the limited evidence for specific blood pressure thresholds and recognizing the gaps that necessitate a more individualized strategy.
Non-Invasive Neuromonitoring: Exploring the potential of non-invasive near-infrared spectroscopy and non-invasive intracranial pressure monitoring as feasible alternatives to invasive methods, allowing for personalized blood pressure management without unnecessary interventions.
Future of Personalized Medicine: Envisioning the role of non-invasive neuromonitoring in shaping the future of personalized medicine for SAH and pave the way for discussions on the current pitfalls, feasibility and need for clinical trials.
Conclusion:
This session invites neurocritical care practitioners to delve into the future of dynamic blood pressure management using invasive and non-invasive neuromonitoring, and discuss the current literature and pitfalls.
Blood pressure thresholds evolve through distinct phases of SAH care. Despite the fact that establishing specific blood pressure goals and induced hypertension after SAH are ubiquitous in clinical practice, there remains no evidence supporting this practice, and the latest American Heart Association and Neurocritical Care Society guidelines make no recommendations on specific blood pressure thresholds and make a cautious recommendation on induced hypertension. This talk will explore the supporting literature and pitfalls in the potential role of non-invasive and invasive neuromonitoring as tools for individualizing blood pressure goals and perfusion thresholds in SAH using cerebral autoregulation.
Session Objectives:
Dynamic Blood Pressure Goals: Unpacking the shifting targets in blood pressure management across SAH phases, emphasizing the need for personalized approaches before aneurysm securement, before and after delayed cerebral ischemia.
Current Gaps: Shedding light on the limited evidence for specific blood pressure thresholds and recognizing the gaps that necessitate a more individualized strategy.
Non-Invasive Neuromonitoring: Exploring the potential of non-invasive near-infrared spectroscopy and non-invasive intracranial pressure monitoring as feasible alternatives to invasive methods, allowing for personalized blood pressure management without unnecessary interventions.
Future of Personalized Medicine: Envisioning the role of non-invasive neuromonitoring in shaping the future of personalized medicine for SAH and pave the way for discussions on the current pitfalls, feasibility and need for clinical trials.
Conclusion:
This session invites neurocritical care practitioners to delve into the future of dynamic blood pressure management using invasive and non-invasive neuromonitoring, and discuss the current literature and pitfalls.
Breakout Session
Delivery, Quality and Safety
Diversity, Equity, and Inclusion
Global Neurocritical Care
Hospitalist Practice
Patient Education
Intermediate
Advanced
DescriptionDr. Prust will present on data collected from Zambia on the burden of critical illness among neurology inpatients at Zambia’s primary referral hospital, the availability and spectrum of ICU care, the key drivers of critical illness and in-hospital mortality, and the role of protocolized care for prevention and early-recognition of life-threatening complications, as well as decision-support tools for ICU triage. While these findings are specifically derived from Zambia, they highlight issues that arise commonly in low- and middle-income countries worldwide, and I’ll be sure to emphasize the generalizability to other global contexts.
Breakout Session
Delivery, Quality and Safety
Bedside Nursing
Global Neurocritical Care
NCC Fellowship/Training
Pediatric
Provider Education Topics (eg fellowship training, competency assessment, etc)
Intermediate
DescriptionNeurocritical care teams operate in a dynamic, high stakes environment that requires effective teamwork among multiple disciplines. In this setting, non-technical interpersonal skills are crucial and significantly impact patient outcomes. Simulation training and effective debriefing can enhance these skills by offering a safe and immersive environment for deliberate practice and learning. Yet despite multiple benefits, using regular interdisciplinary simulations to teach non-technical skills is uncommon in neurocritical care. We propose that with thoughtful design, in-situ simulation is a worthwhile investment for neurocritical care teams. During this session, we will describe practical steps for building an interdisciplinary in situ simulation program that trains neurocritical care teams in non-technical teamwork skills.
Effective interdisciplinary simulation training is a collaborative endeavor. Strong simulation programs rely upon trusted facilitators who guide participants through the immersive learning experience. Establishing an interdisciplinary facilitator team can promote buy-in, collaboration, and flattened hierarchy. Multidisciplinary representation provides diversity of facilitator attributes, including proficiency, educational techniques, and preparation, which informs the learners’ simulation experience. While there are many design elements to consider, of paramount importance is the orchestration of debriefing sessions that extract meaningful insights and promote collaborative learning. In this talk, we will: (1) describe how to build a facilitator team for interdisciplinary in situ simulation; (2) propose an interdisciplinary co-facilitation model; and (3) describe application of Debriefing with Good Judgment to simulation exercises focused on nontechnical skills. We will share insights about potential pitfalls and solutions to building an interdisciplinary in situ simulation program in neurocritical care.
Effective interdisciplinary simulation training is a collaborative endeavor. Strong simulation programs rely upon trusted facilitators who guide participants through the immersive learning experience. Establishing an interdisciplinary facilitator team can promote buy-in, collaboration, and flattened hierarchy. Multidisciplinary representation provides diversity of facilitator attributes, including proficiency, educational techniques, and preparation, which informs the learners’ simulation experience. While there are many design elements to consider, of paramount importance is the orchestration of debriefing sessions that extract meaningful insights and promote collaborative learning. In this talk, we will: (1) describe how to build a facilitator team for interdisciplinary in situ simulation; (2) propose an interdisciplinary co-facilitation model; and (3) describe application of Debriefing with Good Judgment to simulation exercises focused on nontechnical skills. We will share insights about potential pitfalls and solutions to building an interdisciplinary in situ simulation program in neurocritical care.
Breakout Session
Science of Neurocritical Care
General Critical Care
Global Neurocritical Care
Informatics
Multimodal Neuromonitoring (invasive/non-invasive)
Subarachnoid Hemorrhage
Traumatic Brain Injury
Introductory
Intermediate
DescriptionThe application of multimodal artificial intelligence (AI) represents a revolutionary approach to the diagnosis, monitoring, and treatment of patients with acute neurological conditions. This approach leverages a variety of AI techniques, including machine learning, deep learning, and natural language processing, to analyze and integrate data from multiple sources, such as neuroimaging, neurophysiology, electronic medical records, and systemic physiology. The essence lies in the ability to harness and synthesize complex, heterogeneous data streams, providing a holistic view of a patient's neurological status in real time. This integration enables the identification of subtle patterns and correlations, thereby enhancing the precision of diagnostic assessments, prognostic predictions, and therapeutic decisions. Multimodal AI facilitates the early detection of critical events, such as the onset of seizures, brain edema, or hemorrhagic transformation, allowing for timely interventions that can significantly impact patient outcomes. AI tools can offer predictive insights into patient trajectories, suggest optimal treatment pathways, and even anticipate potential complications before they become clinically apparent. This proactive approach to patient care is further enriched by the ability of AI to learn from vast datasets, continuously improving its predictive accuracy and operational efficiency through exposure to new patient data. As these AI systems become increasingly sophisticated, they promise to unlock new possibilities in the treatment of neurological emergencies, transforming the landscape of neurocritical care with their potential to improve access, enhance patient outcomes, and optimize resource utilization.
Late-Breaking Abstract
Science of Neurocritical Care
Head and Spine Trauma
Seizures/EEG
Curing Coma
Intermediate
Breakout Session
Science of Neurocritical Care
Informatics
Nursing Pharmacology
Traumatic Brain Injury
Advanced
DescriptionTraumatic brain injury (TBI) is a leading cause of disability in the United States. Current treatments have focused on early surgical intervention to limit hematoma expansion and supportive therapy; however, there are limited pharmacological interventions to reduce long-term cognitive sequelae post-injury. TBI causes a primary injury followed by a secondary biochemical and cellular response, which involves the induction of the neuroinflammatory response, which has been shown to contribute to worsening neurological outcomes after injury. The investigations in TBI have been hampered by the lack of effective immunotherapeutics that could target microglia (brain resident cells) inflammation and improve outcomes after injury. The mucosal immune system is a unique tolerogenic organ that provides a physiological approach for the induction of regulatory T cells (Tregs). Tregs were found to alleviate the inflammatory response by inhibiting microglial inflammation in preclinical TBI studies. Yet, there are still no effective and safe therapies capable of inducing Tregs and improving outcomes after TBI. In this talk, we will report that inducing immune tolerance by targeting nasal mucosa via anti-CD3 is a safe and novel therapeutic approach associated with CNS immune modulation and improvement in long-term behavioral outcomes after injury. Our studies have immediate translational possibilities for treating TBI patients given that a fully humanized anti-CD3 mAb (Foralumab) has been given to healthy volunteers and has shown positive effects in a pilot study of subjects suffering from COVID-19. The content to be presented in this talk has been supported by an NCS Research Training Fellowship.
General Session
DescriptionInforming the audience that the prehospital care system we all take for granted today was designed and implemented to service a neglected and Underserved Black Community and, in doing so, was borne this country's very first Paramedic Service. 1967-1975, Freedom House Ambulance created the first advanced Life Support system in the United States. Notable contributions: CPR, Tracheal Intubation, Narcan Administration (1973), EKG Telemetry, and Vehicle Design. in addition to writing the First Paramedic Training Manual (Emergency Care in the Street) by Our Medical Director Nancy Caroline, published in 1977.
Breakout Session
Clinical Practice
APP Practice
Bedside Nursing
Delirium
General Critical Care
Multimodal Neuromonitoring (invasive/non-invasive)
Neurogenic Respiratory Failure
Intermediate
DescriptionNeed for Mechanical Ventilation (MV) is common in the NSICU but for various underlying conditions such as neuromuscular weakness, inability to maintain a safe airway, or hypoxemic respiratory failure. Different MV prescriptions will be best applied for the individual patient's unique disorder and needs but the common factor is that sedation and paralytics should potentially be avoided or minimized to not only allow for an accurate neurological examination but to also optimize their cerebrovascular supporting parameters (cardiac output, blood pressure, ICP, etc). We will review the data supporting historical as well as modern MV strategies that can be best applied to NSICU patients.
Breakout Session
Delivery, Quality and Safety
APP Practice
NCC Fellowship/Training
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionImposter syndrome is a psychological pattern where individuals doubt their accomplishments, feel anxious, and deny their success internally, despite having objective evidence of success. This condition is particular common in medicine during transition periods, like moving from a trainee to a faculty. The pressure to perform, the weight of new responsibility, and a shift in one’s identity can exacerbate feelings of inadequacy. This talk will delve into the factors that contribute to imposter syndrome, challenges one may face during the transition from trainee to faculty, and elucidate ways to overcome and strategize ways to cope in this pivotal time. This talk will also focus on individual resources, local institutional resources, and national resources available to assist with early career and new faculty development to maximize success.
Breakout Session
Science of Neurocritical Care
Basic/Neurocritical Care 101
General Critical Care
Intracerebral Hemorrhage
Multimodal Neuromonitoring (invasive/non-invasive)
Nursing Pharmacology
Pharmacist Practice
Stroke
Subarachnoid Hemorrhage
Traumatic Brain Injury
Intermediate
DescriptionThe acute hypertensive response observed in ICH is associated with poor outcome, and the risk for hematoma expansion. Intensive blood pressure reduction has been studied in multiple large randomized controlled trials with conflicting results. Several studies have suggested the potential risk of cerebral ischemia with overly aggressive blood pressure reduction detected with the use of diffusion-weight MRI. With comorbid severe hypertension and underlying cerebral small vessel disease, alteration and impairment in cerebral autoregulation have been associated with secondary cerebral ischemia and may provide future directions for personalized blood pressure targets after ICH to maximize risk-benefit ratio in hemodynamic control. In this talk, we will review current body of evidence pertaining to acute blood pressure management after intracerebral hemorrhage, gaps in the literature, mechanisms of DWI lesions after ICH, and novel research exploiting the potential of cerebral autoregulation-informed blood pressure targets to advance treatment targets.
Special Topic and Curated Session
Clinical Practice
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
DescriptionPharmacists within NCS have a long history of mentoring colleagues to be future leaders in the Society and within the field of Neurocritical care, which is reflected in the number of pharmacists who have received FNCS designation. This session will use examples from FNCS-designated pharmacists that demonstrate excellence in these four focus areas required for FNCS designation: program development, scholarship, leadership and professionalism/collaboration. Strategies to assist pharmacists and other clinicians in identifying leadership opportunities will be reviewed including: New Member Information, Speaker/topic inventory , and mentorship opportunities. This talk is meant to be part of a three-part series, with the first talk being on general FNCS requirements and a second talk focused on APPs' experience with FNCS.
Breakout Session
Delivery, Quality and Safety
APP Practice
Diversity, Equity, and Inclusion
Global Neurocritical Care
Informatics
Patient Education
Provider Education Topics (eg fellowship training, competency assessment, etc)
Introductory
Intermediate
DescriptionI propose to discuss how to harness the power of AI to decrease local and global disparities in Neurocritical Care. As research accumulates demonstrating the burden of inequitable care in Neurocritical Care, we need to refocus our attention on ameliorating the disparities. One practical way to achieve this goal is to use existing and forthcoming AI technology to ensure fairness and equity. This talk will discuss action items to mitigate disparities locally, national and globally. I will cover current and future technologies such as automated TCD interpretations, global use of portable and low tesla MRI, AI augmented robot assisted surgeries such as thrombectomy, automated language translation for acute neurologic care, and follow up augmented assistance to families for diminishing burden such as virtual medication assistance and compliance. Finally I will discuss the pitfalls and potential bias that is inherent to AI that also might accentuate disparities.
Breakout Session
Clinical Practice
Coma
Multimodal Neuromonitoring (invasive/non-invasive)
Pediatric
Provider Education Topics (eg fellowship training, competency assessment, etc)
Status Epilepticus
Intermediate
DescriptionIn the rapidly evolving field of pediatric neurocritical care, the integration of genetic diagnoses and quantitative EEG (qEEG) is paving the way for precision medicine. We will explore the latest advancements using case vignettes to highlight how rapid or known genetic testing allows for a more accurate diagnosis and prognosis and tailored therapies contributing to improved outcomes. Concurrently, we will examine how qEEG can be used to both monitor and measure cerebral function but also identify trends in seizure responsiveness that otherwise are difficult to identify.
Our discussion will begin with an examination of gain-of-function sodium channelopathies (SCN2A & SCN8A), which are some of the most common cause of early genetic epilepsies and can be targeted with sodium channel drugs. Cases presented will highlight how early diagnosis can improve seizure control with aggressive dosing regimens targeting high or "supra" therapeutic levels.
Next, the session will cover the role of qEEG in monitoring the efficacy of seizure therapies. Attendees will learn how real-time brain activity data can inform adjustments to treatment plans, ensuring that each child receives the most effective therapy based on their unique neurophysiological responses.
Finally, we will delve into the prognostic value of qEEG following cardiac arrest in children. New data continues strengthen the link between qEEG features (e.g., suppression ratio, and relative beta, alpha and delta activity) and the likelihood of neurological recovery. These features many help families make informed decisions about care and allow bedside providers to trend novel neuroprotective biomarkers.
Our discussion will begin with an examination of gain-of-function sodium channelopathies (SCN2A & SCN8A), which are some of the most common cause of early genetic epilepsies and can be targeted with sodium channel drugs. Cases presented will highlight how early diagnosis can improve seizure control with aggressive dosing regimens targeting high or "supra" therapeutic levels.
Next, the session will cover the role of qEEG in monitoring the efficacy of seizure therapies. Attendees will learn how real-time brain activity data can inform adjustments to treatment plans, ensuring that each child receives the most effective therapy based on their unique neurophysiological responses.
Finally, we will delve into the prognostic value of qEEG following cardiac arrest in children. New data continues strengthen the link between qEEG features (e.g., suppression ratio, and relative beta, alpha and delta activity) and the likelihood of neurological recovery. These features many help families make informed decisions about care and allow bedside providers to trend novel neuroprotective biomarkers.