Departments of *Anesthesiology †Medicine (Neurology) ‡Brain Injury Translational Research Center, Duke University, Durham, NC §Departments of Anesthesiology and Perioperative Medicine, Neurologic Surgery and Neurology, Oregon Health and Science University, Portland, OR.
J Neurosurg Anesthesiol. 2014 Jan;26(1):11-6. doi: 10.1097/ANA.0b013e31829e705e.
A group of anesthesiologists practice as intensivists in neurointensive care units (NeuroICU). The current nature and implications of the role of anesthesiology-based neurointensivist remain unclear. The purpose of this survey was to assess today's practice environment of anesthesiology-based neurointensivists as a framework for future study.
During the period between January 2011 and March 2011, we identified anesthesiologists who provide patient care in specialized NeuroICUs in the United States. We used an online, 15-question survey to gauge the environment and their role in the delivery of care to critically ill patients admitted to NeuroICUs.
Of the 104 NeuroICUs in the United States, 22 institutions include anesthesiology-based neurointensivists (n=41). With a response from 33 of 41 requested surveys, anesthesiology-based neurointensivists reported that background training and roles for providing patient care in the NeuroICU setting varied widely between institutions. In contrast, these practices were similar in providing 24-hour coverage (76%), working with neurosurgical (88%) and anesthesiology residents (85%), and having critical-care fellowship training (97%). Almost all surveyed individuals practice both neurocritical care and anesthesia in the operating room, and 76% reported satisfaction with their working environment in the NeuroICU relative to other responsibilities.
Anesthesiology-based neurointensivists currently represent a small subgroup within the rapidly growing neurointensivist workforce in the United States and consider neurocritical care a valuable aspect of their career. Promoting subspecialty training in neurocritical care among anesthesiologists may provide an opportunity for new patient-care frontiers and address the increasing need for NeuroICU physicians.
一群麻醉医师以神经重症医师的身份在神经重症监护病房（NeuroICU）执业。目前，麻醉医师作为神经重症医师的角色性质和意义尚不清楚。本调查的目的是评估麻醉医师作为神经重症医师的当前实践环境，为未来的研究提供框架。
在 2011 年 1 月至 2011 年 3 月期间，我们确定了在美国专门的 NeuroICU 提供患者治疗的麻醉医师。我们使用在线的 15 个问题调查来评估环境及其在向NeuroICU 收治的危重病患者提供治疗方面的作用。
在美国的 104 个 NeuroICU 中，有 22 个机构包括麻醉医师为基础的神经重症医师（n=41）。在请求的 41 份调查中有 33 份做出了回应，麻醉医师为基础的神经重症医师报告称，其在 NeuroICU 环境中提供患者治疗的背景培训和角色在各机构之间差异很大。相比之下，在提供 24 小时覆盖（76％）、与神经外科医生（88％）和麻醉住院医师（85％）合作以及接受重症监护 fellowship培训（97％）方面，这些实践是相似的。几乎所有接受调查的个人都在神经重症监护病房和手术室同时进行神经重症监护和麻醉，76％的人表示相对于其他职责，他们对在 NeuroICU 的工作环境感到满意。
麻醉医师为基础的神经重症医师目前在美国迅速发展的神经重症医师队伍中仅占一小部分，并且认为神经重症监护是其职业生涯的有价值的方面。在神经重症监护方面促进麻醉医师的亚专业培训可能为新的患者护理前沿提供机会，并满足对 NeuroICU 医师的日益增长的需求。
