The Evolution of Neurocritical Care in the Philippines
By Joanne B. Robles, MD and Geraldine Siena L. Mariano, MD
In the Philippines,
rank as the second
most common cause
of mortality in the
reports in 2017. Other
neurological diseases that
require intensive care
management like status
epilepticus and traumatic
brain injury are unfortunately underreported leading to a lack of
epidemiologic data. As technological advances moved us further
into discovering more efficient and expedient means of preventing
and protecting the injured brain from further insult and ensuring
improved recovery and reduced mortality, the role of intensive
neurologic management cannot be understated. This became the
driving impetus for Filipino neurologists and other specialists to
take an interest in the care of the critically ill patient with primary
and secondary neurologic dysfunction. Neurocritical care has thus
become an emerging subspecialty in the practice of neurology in
the Philippines. The advances in the care of the neurocritically
ill patient have paved the way for multidisciplinary specialists to
improve outcomes of Filipino patients.
Over the past decade, tertiary high-volume hospitals in Metro
Manila have begun to revolutionize the manner by which
healthcare is delivered to patients with neurological diseases that
require focused neurocritical care. Advancements in neuroimaging,
neurosurgical techniques and thrombolysis in acute stroke care
are now in local practice. Hospitals in Philippine urban cities
now have Brain Attack Teams that ensure early recognition and
management of acute ischemic stroke. Mechanical thrombectomy
has likewise become a feasible option over the past few years.
However, the access to specialized healthcare is marginalized in
the cities outside of metropolitan Manila, and these therapeutic
advances still cannot be delivered to every neurologic patient.
Recognizing these gaps in neurocritical care, a group of specialists
gathered to formally discuss the founding of the Philippine
Neurocritical Care Society (PNCS) on May 10, 2017. The meeting
was held at St. Luke’s Medical Center in Quezon City, Philippines.
The meeting was presided by Dr. Geraldine Siena Mariano and
Dr. Abdias Aquino. The nonprofit organization is made up of
experts and recognized leaders in various disciplines, such as
neurocritical care, endovascular, neurosurgery, critical care, stroke,
neuroradiology, clinical nutrition, rehabilitation medicine,
nursing, clinical pharmacy and respiratory therapy from different
institutions. The society is an affiliate of the NCS International
Affiliates Program and it aims to reflect the mission statement of
the Neurocritical Care Society.
The PNCS seeks to create local programs to educate and empower
healthcare professionals in optimizing the delivery of neurocritical
care especially in far-flung areas where there is limited access
to care. Among the long-term goals of the organization is the
development of local management guidelines that will allow
standardization of care of the neurocritically ill patient even in
hospitals with limited resources and the creation of hospital
networks that will allow the expedient and coordinated transfer of
patients to tertiary hospitals where optimal care can be provided.
Geraldine Siena L.
The first Philippine Neurocritical Case Society (PNCS) meeting held in St. Luke’s
Medical Center- Quezon City last May 10, 2017.
at St. Luke’s Medical
Center, Quezon City,
The NCCU team at St. Luke’s Medical Center.