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Children's Hospital Boston is now home to the first multidisciplinary and comprehensive Pediatric Neurocritical Care Program in the nation. The program brings together Children's experts in the Medical and Surgical Intensive Care Unit (MSICU), critical care medicine, neurology, neurosurgery, neuroanesthesia, neuroradiology and stroke in a coordinated model of tertiary and quaternary care that centers on protecting and treating the brains of critically ill and injured children.
Program basics
The Pediatric Neurocritical Care Program, applying key insights gleaned from adult neurocritical care units, is embedded within Children's MSICU. Clinicians monitor each child to assess the physiologic effects of his specific injury or illness and use their observations to adapt customized treatment plans with an aim to protect the patient's developing brain.
Robert C. Tasker, MB, BS, MD, established and directs the Pediatric Neurocritical Care Program. Dr. Tasker, the first physician in the United Kingdom to train in pediatric neurointensive care, came to Children's last year from the Cambridge University (UK) Foundation Trust Hospital. Previously, he directed the General Medical Intensive Care Unit at London's Great Ormond Street Hospital for Children.
While the program intersects with multiple clinical departments and services at Children's, Dr. Tasker works most closely with a core group of physicians and nurses in the MSICU and neurosurgeons in the operating room. All of these clinicians have extensive knowledge about the developing brain and significant expertise treating pediatric neurocritical patients.
In scale and in practice, the Pediatric Neurocritical Care Program is unlike any effort at a pediatric hospital in the United States.
Patients treated
The Pediatric Neurocritical Care Program becomes involved in care at the point when a patient either requires life-saving intervention or has become dependent on life-saving technologies. This includes, but is not limited to, children with:
The program not only serves children with preexisting neurological illnesses, it also adds a dimension of neurological care for many other patients in the ICU: those who are on ventilators, experiencing critical illness or undergoing major surgical procedures.
Our innovative approach
Children's Pediatric Neurocritical Care Program uses the most sophisticated diagnostic tools available, including:
- Bedside brain CT imaging
- 3 Tesla MRI scanner adjacent to the ICU
- Intensive neuromonitoring
The program also plans to make significant additions in the future, including the introduction of:
- Near-infrared spectroscopy
- Signal-processed EEG monitoring
- Transcranial Doppler
- Non-invasive hemodynamic monitoring and integrative physiology
- A Late Outcomes White Matter Clinic to follow patients with severe traumatic brain injury
Research
The Pediatric Neurocritical Care Program is devoted to clinical research with the potential to optimize conditions for brain recovery. Current research focuses include:
- Assessment of heart and brain interactions
- Cerebral metabolism
- Cerebrovascular autoregulation
- Collaboration with the Massachusetts Institute of Technology on signal processing and computational physiology
- Brain function assessment and substructure networks in coma
- Neuropharmacology and therapeutics for refractory status epilepticus
The program is also engaged in national and international collaborations in traumatic brain injury.
Referrals and second opinions
The Pediatric Neurocritical Care Program at Children's welcomes referrals and requests for second opinions from other clinicians in the community, as well as nationally and internationally. Typically, referrals are for children with the above or related conditions who have been hospitalized in an ICU.
Make a referral: 617-355-7327
Robert C. Tasker
MB, BS, MD
Director
Michael L. McManus MD, MPH
Senior Associate in Critical Care Medicine
and Perioperative Anesthesia
Kerri L. LaRovere, MD
Assistant in Neurolog
Meredith Giglia van der Velden, MD
Assistant in Critical Care Medicine
Patricia Meehan
RN, BSN, CCRN
Nurse Educator in the Medical Surgical Intensive Care Unit
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