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. 2023 Feb 21:14:1114204.
doi: 10.3389/fneur.2023.1114204. eCollection 2023.

The development of neurocritical care in China from the perspective of evaluation and treatment of critical neurological diseases

Yingying Su  1 , Junfang Teng  2 , Fei Tian  1 , Jing Jing  2 , Huijin Huang  1 , Suyue Pan  3 , Wen Jiang  4 , Furong Wang  5 , Le Zhang  6 , Yan Zhang  1 , Meng Zhang  7 , Liping Liu  8 , Jie Cao  9 , Huaiqiang Hu  10 , Wei Li  7 , Cheng Liang  11 , Liansheng Ma  12 , Xuegang Meng  13 , Linyu Tian  14 , Changqing Wang  15 , Lihua Wang  16 , Yan Wang  17 , Zhenhai Wang  18 , Zhiqiang Wang  19 , Zunchun Xie  20 , Mingyao You  21 , Jun Yuan  22 , Chaosheng Zeng  23 , Li Zeng  24 , Lei Zhang  25 , Xin Zhang  26 , Yongwei Zhang  27 , Bin Zhao  28 , Saijun Zhou  29 , Zhonghe Zhou  30
Affiliations

The development of neurocritical care in China from the perspective of evaluation and treatment of critical neurological diseases

Yingying Su et al. Front Neurol. .

Abstract

Objective: To understand the varieties, evaluation, treatment, and prognosis of severe neurological diseases using the third NCU survey in China.

Design: A cross-sectional questionnaire study. The study was completed in three main steps: filling in the questionnaire, sorting out the survey data, and analyzing the survey data.

Results: Of 206 NCUs, 165 (80%) provided relatively complete information. It was estimated that 96,201 patients with severe neurological diseases were diagnosed and treated throughout the year, with an average fatality rate of 4.1%. The most prevalent severe neurological disease was cerebrovascular disease (55.2%). The most prevalent comorbidity was hypertension (56.7%). The most prevalent complication was hypoproteinemia (24.2%). The most common nosocomial infection was hospital-acquired pneumonia (10.6%). The GCS, APACHE II, EEG, and TCD were the most commonly used (62.4-95.2%). The implementation rate of the five nursing evaluation techniques reached 55.8-90.9%. Routinely raising the head of the bed by 30°, endotracheal intubation and central venous catheterization were the mostprevalent treatment strategies (97.6, 94.5, and 90.3%, respectively). Traditional tracheotomy, invasive mechanical ventilation and nasogastric tube feeding (75.8, 95.8, and 95.8%, respectively) were more common than percutaneous tracheotomy, non-invasive mechanical ventilation and nasogastric tube insertion (57.6, 57.6, and 66.7%, respectively). Body surface hypothermia brain protection technology was more commonly used than intravascular hypothermia technology (67.3 > 6.1%). The rates of minimally invasive hematoma removal and ventricular puncture were only 40.0 and 45.5%, respectively.

Conclusion: In addition to traditional recognized basic life assessment and support technology, it is necessary to the use of promote specialized technology for neurological diseases, according to the characteristics of critical neurological diseases.

Keywords: NCCU; critical neurological disease; evaluation; investigation; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Investigation process. NCC, neurocritical care; NCCU, neurocritical care unit.
Figure 2
Figure 2
The proportion of diseases in 165 NCCU patients in 2020. Other neurological diseases include demyelinating disease, metabolic encephalopathy, postcranial/spinal surgery, etc.
Figure 3
Figure 3
Proportion of 165 NCCU evaluation technologies in 2020.
Figure 4
Figure 4
Proportion of 165 NCCU treatment technologies in 2020.
See this image and copyright information in PMC

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