Consensus statement on standards for neurocritical care units in low-income and middle-income countries (LMICs)
Issued Date
2026-02-01
Resource Type
ISSN
08839441
eISSN
15578615
Scopus ID
2-s2.0-105020891780
Pubmed ID
41110431
Journal Title
Journal of Critical Care
Volume
91
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Critical Care Vol.91 (2026)
Suggested Citation
Shrestha G.S., Prabhakar H., Mahajan C., Kapoor I., Livesay S.L., Rajajee V., Zirpe K., Videtta W., Hossain S., Silva G.S., Rubiano A.M., Raheem M.S.A., Pina Y., Wanchoo J., Shukla U., Tripathy S., Singhal V., Margaretha R.E., Tsan S., Yimer F.T., Lamsal R., Salisu-Kabara H., Pinedo J.L., Soliven J.A.R., Popugaev K., Padayachy L.C., Shanmugam P., Viarasilpa T., Arun O., Van Bui T. Consensus statement on standards for neurocritical care units in low-income and middle-income countries (LMICs). Journal of Critical Care Vol.91 (2026). doi:10.1016/j.jcrc.2025.155296 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114418
Title
Consensus statement on standards for neurocritical care units in low-income and middle-income countries (LMICs)
Author(s)
Shrestha G.S.
Prabhakar H.
Mahajan C.
Kapoor I.
Livesay S.L.
Rajajee V.
Zirpe K.
Videtta W.
Hossain S.
Silva G.S.
Rubiano A.M.
Raheem M.S.A.
Pina Y.
Wanchoo J.
Shukla U.
Tripathy S.
Singhal V.
Margaretha R.E.
Tsan S.
Yimer F.T.
Lamsal R.
Salisu-Kabara H.
Pinedo J.L.
Soliven J.A.R.
Popugaev K.
Padayachy L.C.
Shanmugam P.
Viarasilpa T.
Arun O.
Van Bui T.
Prabhakar H.
Mahajan C.
Kapoor I.
Livesay S.L.
Rajajee V.
Zirpe K.
Videtta W.
Hossain S.
Silva G.S.
Rubiano A.M.
Raheem M.S.A.
Pina Y.
Wanchoo J.
Shukla U.
Tripathy S.
Singhal V.
Margaretha R.E.
Tsan S.
Yimer F.T.
Lamsal R.
Salisu-Kabara H.
Pinedo J.L.
Soliven J.A.R.
Popugaev K.
Padayachy L.C.
Shanmugam P.
Viarasilpa T.
Arun O.
Van Bui T.
Author's Affiliation
University of Michigan, Ann Arbor
Monash University
Universidade Federal de São Paulo
All India Institute of Medical Sciences, New Delhi
Siriraj Hospital
Symbiosis International (Deemed University)
Universiti Malaysia Sarawak
Faculty of Medicine
University of Namibia
All India Institute of Medical Sciences, Bhubaneswar
Universidad El Bosque
Medanta - The Medicity
Tribhuvan University Teaching Hospital
Aminu Kano Teaching Hospital
Selçuk Tip Fakültesi
Steve Biko Academic Hospital
College of Nursing
Hospital Nacional Professor Dr. Alejandro Posadas
Cho Ray Hospital
Ruby Hall Clinic
The National Hospital Kandy
Greater Accra Regional Hospital
Baiturrahmah University
United Hospital Limited
National Medical Research Centre of Paediatrics
The Medical City – Ortigas
Clinicas AUNA
Monash University
Universidade Federal de São Paulo
All India Institute of Medical Sciences, New Delhi
Siriraj Hospital
Symbiosis International (Deemed University)
Universiti Malaysia Sarawak
Faculty of Medicine
University of Namibia
All India Institute of Medical Sciences, Bhubaneswar
Universidad El Bosque
Medanta - The Medicity
Tribhuvan University Teaching Hospital
Aminu Kano Teaching Hospital
Selçuk Tip Fakültesi
Steve Biko Academic Hospital
College of Nursing
Hospital Nacional Professor Dr. Alejandro Posadas
Cho Ray Hospital
Ruby Hall Clinic
The National Hospital Kandy
Greater Accra Regional Hospital
Baiturrahmah University
United Hospital Limited
National Medical Research Centre of Paediatrics
The Medical City – Ortigas
Clinicas AUNA
Corresponding Author(s)
Other Contributor(s)
Abstract
The disease burden of severe neurological and neurosurgical illnesses in low-income and middle-income countries (LMICs) is high. Management of these patients by a dedicated neurocritical care team can improve outcome. Globally, there is significant variation in organization, structure, and outcome of patients with neurocritical illnesses. This consensus statement aims to contextualize the standards for neurological critical care units (NCCUs) in LMICs. Recommendations were made about organization and infrastructure, personnel, logistics, training, education, and process for developing neurocritical care program appropriate for LMICs. Methods: The steering committee for the consensus statement was formed under the leadership of Society of Neurocritical Care (SNCC), India. With permission from Neurocritical Care Society (NCS) and the NCS guidelines committee, the previously published standards for NCCUs by NCS was used for a web-based survey. The Delphi method was used to gather consensus. A total of 28 experts from 21 nations, all from LMICs, participated in the Delphi. Responses were formally collated, reviewed, and incorporated into the final document. For Level 1 NCCUs, we found that LMIC experts have recommended few parameters that were considered optional by NCS. However, for Level 2 and 3 ICUs, many recommendations from NCS were suggested to be considered as optional by LMIC experts. We have made attempts to explain the variation in recommendations. The recommendations should be tested for feasibility at the local settings before implementing them.