Investing in Effective Brain Teams
By Lindsay Doucette
According to the National Institutes of Health, “The brain makes up only 2 percent of our body weight, but it consumes 20 percent of the oxygen we breathe and 20 percent of the energy we consume.” The human brain is both highly complex and highly sensitive, which is why it’s no surprise that acute brain injuries, such as traumatic brain injury and stroke, are a leading cause of death and disability worldwide.
The brain is dependent on the body for a constant supply of fuel, namely oxygen and glucose. If it experiences a lack of fuel for more than five minutes, there can be severe complications including cognitive dysfunction, coma, brain damage, or death. One of the goals of neurocritical care, therefore, is to maintain the flow of fuel to the brain to prevent secondary injury.
Neurocritical care is one of the newest subspecialties in medicine and marks an important leap forward in the care of neurological patients. Due to the complexity of the brain, it is difficult to integrate brain pathophysiology into standard intensive care training. Yet knowledge of the brain in ICU management is crucial to successful outcomes.
Dr. Deepak Sharma and Dr. Lucia Rivera Lara demonstrate the use of transcranial doppler with Paraguayan intensive care and anesthesia residents and fellows.
Increasingly, the Solidarity Bridge Neurosurgery and Neurology Institute (NNI) is working with key public hospital partners in Paraguay and Bolivia to develop holistic “brain teams” to improve clinical outcomes for patients with neurological disorders. Beginning with data collection, we’ve gained information about the current state of neurological care and hope to measure the impact of our neuro-specific training in anesthesia, surgery, critical care, and rehabilitation.
Through virtual and in-person exchanges, research, and training, we are supporting the development of complete and effective brain teams at our partner hospitals. Our long-term goal is to improve outcomes for the high volume of neurological patients these hospitals treat day-in and day-out.
This work began in 2019 with inter-disciplinary baseline studies of neurological care provision. There was a pause at the height of the Covid-19 pandemic, but our efforts continued in earnest in 2022. Over the past year, we have increased our focus in neurocritical care development with the contributions of Dr. Lucia Rivera Lara, a neurointensivist from Stanford University.
Dr. Lucia Rivera Lara and Dr. Deepak Sharma (center) with Dr. Arnaldo Noguera (l) and Dr. Jorge Flecha (r) of the Paraguayan Society of Critical and Intensive Care at a meeting of the Society.
On a recent trip to Paraguay, Dr. Rivera Lara provided daily lectures and hands-on instruction along with neuro-anesthesiologist Dr. Deepak Sharma from the University of Washington. Dr. Rivera Lara and Dr. Sharma provided training to over 40 intensive care, internal medicine, and anesthesia residents and doctors at the Hospital Nacional de Itauguá. They were also invited to speak to the Paraguayan Societies of Neurosurgery, Anesthesia, and Critical and Intensive Care. Our training will continue in the coming months through virtual conferences, exchanges, data collection, and in-person practical courses. On June 29th, the NNI will collaborate with Dr. Sharma and the University of Washington Global Anesthesia Initiative to offer our first virtual Neuroanesthesia Symposium for anesthesia partners in Latin America.
The stakes are high for patients who require expert neurological care and, unfortunately, there are many of them. The NNI recognizes the urgent need for effective brain teams both at home and abroad. We hope that our collaborative efforts in Bolivia and Paraguay will benefit many patients and the families who love and depend on them. And we are committed to ensuring that the skills and knowledge being developed in this important new subspecialty can be made accessible to health care providers throughout the world.
Through partnerships and collaborative actions that are measurable and sustainable, the Neurosurgery and Neurology Institute works to build capacity and expertise in Bolivia and Paraguay in order to increase access to safe, affordable and timely health care.
We are committed to alleviating the suffering, death and disability from neurological disorders and injuries that disproportionately impact patients in the countries where we serve.