Neurocritical Care for Paediatric Neurosurgery: Perspectives from a Nigerian Tertiary Institution

Abstract

Abstract Background: Neurocritical care is indispensable for the optimal management of neurosurgical patients; however, its status in sub-Saharan Africa remains nascent. Relevant epidemiological data are essential for enhancing the treatment outcomes of paediatric neurosurgical patients; however, no public data exist on their critical care requirements. Materials and Methods: This is a retrospective study of the clinical records of all paediatric neurosurgical patients admitted into our facility’s paediatric intensive care unit (PICU) from March 2022 to July 2024. Results: We managed 32 neurosurgical patients in our hospital’s PICU during the study period. These had a male-to-female ratio of 1.9:1. The patients ranged in age from three months to 16 years, with a mean age of 3.4 years. Most referrals came from public healthcare facilities, accounting for 56.3% (18/32) of cases. The predominant indication for PICU admission was post-operative care (22/32; 68.75%), 14 (63.6%) of which were brain tumour-related. Eight (25.0%) of these patients were managed for traumatic brain injury (TBI). The Glasgow Coma score at presentation was ≤ 8 in 17 (53.1%) of the patients, while 24/32 (75%) of the patients required ventilatory support. The combined monthly income of 40.6% (13 parents) exceeded 200,000 Naira. Nineteen (59.4%) cases spent ≤ 7 days in PICU, and the 30-day survival rate was 75%. Conclusion: The main indications for PICU admission in our series were TBI and post-operative care for brain tumours, with favourable treatment outcomes observed in most of the patients. These findings underscore the need for standardised management protocols for TBI and post-operative neuro-oncological care in paediatric neurocritical care in Nigeria.