At the recent Annual Meeting of the Colombian Intensive Care Society, a dedicated discussion forum brought together political, academic, and scientific leaders to explore the current state of neuromonitoring, address its challenges, and develop a strategic action plan.  In this summary, we will provide a comprehensive overview of the key topics discussed during the forum.

Current State of Neuromonitoring in Colombia

Neuromonitoring in Colombia faces several challenges, including limited access to advanced technologies, insufficient training for healthcare professionals, and a lack of data collection on traumatic brain injuries. A recent survey by the Colombian Intensive Care Society revealed that only 25% of respondents (n= 69) use intraparenchymal intracranial pressure (ICP) monitoring, while 80% use intraventricular ICP monitoring. Importantly, many providers express concerns regarding their ability to interpret neuromonitoring data accurately, which can lead to suboptimal patient care. Additionally, the absence of national registries for acute brain injuries and disparities in access to neuromonitoring raise ethical concerns, requiring a comprehensive, multifaceted solution.

Proposed Strategy for Enhancing Neuromonitoring

1. Accreditation Requirements

A proposal has been made to make neuromonitoring a standard requirement for critical care unit accreditation. This would encourage healthcare facilities to invest in necessary technologies and training, improving care for neurocritical patients and ensuring a consistent standard of practice across all units.

2. Funding and Resource Allocation

To implement neuromonitoring effectively, dedicated funding is needed for equipment acquisition, with a focus on equitable resource distribution, especially in underserved areas. Prioritizing funding will help close gaps in care and improve patient outcomes nationwide.

3. Training and Education

Continuous education and certification programs for healthcare professionals are vital for improving neuromonitoring practices and equipping providers with the skills needed to accurately interpret neuromonitoring. Investing in such education will boost professionals’ competency in managing neurocritical patients and enhance overall patient care. 

4. Infrastructure Development

Upgrading facilities for neuromonitoring involves enhancing both physical infrastructure and technological capabilities, creating an environment that supports effective patient management and advanced monitoring techniques.

5. Research and Development

Funding research on the impact of neuromonitoring is crucial to proving its clinical value and improving patient outcomes. Promoting innovation in cost-effective technologies will also increase accessibility for healthcare facilities.

6. Policy and Legislation

Enacting legislation to incorporate neuromonitoring into standard care is crucial for ensuring equitable access. Strengthening patient rights and advocating for inclusion in national healthcare policies will help address ethical disparities in care.

7. Best Practices Exchange

Collaboration with international organizations is essential for sharing knowledge and improving neuromonitoring practices. Engaging with global experts will foster continuous improvement and adaptation of successful models to Colombia’s unique environment.

8. Global Standards Alignment

Aligning national standards with international benchmarks will enhance the quality of neuromonitoring care, improving patient outcomes through evidence-based guidelines and protocols.

The discussion emphasized the importance of interdisciplinary collaboration among medical specialties, such as neurologists, neurosurgeons, intensivists, nurses, and therapists, to create a more integrated approach to patient care. 

It was also noted that there is a need for training programs in smaller cities and underserved areas where healthcare professionals have limited access to neuromonitoring education. These programs are essential for building capacity and improving care, ultimately helping to close the disparity gap within the country. 

Additionally, the potential economic benefits of improved clinical outcomes from neuromonitoring are significant. By enhancing patient care and reducing complications, healthcare facilities can shorten hospital stays and lower associated costs. Better clinical outcomes can also optimize resource allocation, increase efficiency within the healthcare system, and facilitate quicker patient reintegration into society.

From left to right: Éder Cáceres MD, PhD; Jorge Carrizosa MD, MS, NVS; Fermín Naranjo MD; Alfredo Miranda MD; Jorge Mejía MD, MS, FNCS; Andres Mariano Rubiano MD, PhD; Rubén Camargo MD, MS. Leaders convene at the Annual Meeting of the Colombian Intensive Care Society to discuss the future of neuromonitoring in Colombia.

Conclusion

The comprehensive strategy detailed in the document offers a clear roadmap for advancing neuromonitoring in critical care units across Colombia. By addressing current challenges and adopting the proposed solutions, the healthcare system can expand access to neuromonitoring technologies, strengthen training for healthcare professionals, and ultimately enhance patient outcomes. Successful implementation will require collaborations among stakeholders, including government agencies, healthcare providers, and local communities. Through collective effort, Colombia can build a more equitable and efficient healthcare system for neurocritical patients. 

[Note: The authors and forum speakers are currently preparing a detailed document of the discussion for future publication.]

To read the Spanish version, please click here.