Expert Consensus on Neurocritical Care Monitoring and Management in Beijing and Tibet(2025)

Drolma PHURBU; Wenjin CHEN; Heng ZHANG; Jian ZHANG; Xiaomeng WANG; Guoying LIN; Wenjun PAN; Xiying GUI; Xin CAI; Chodron TENZIN; Jianlei FU; Qianwei LI; TSEYANG; Yijun LIU; Bo LIU; Tsering DROLMA; Yudron SONAM; KYILV; Samdrup TSERING; Wa DA; Juan GUO; Cheng QIU; Huan CHEN; Xiaoting WANG; Yangong CHAO; Dawei LIU; Wenzhao CHAI; Chenggong HU; Wanhong YIN; Shihong ZHU

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Expert Consensus on Neurocritical Care Monitoring and Management in Beijing and Tibet(2025)

VernacularTitle:京藏神经重症监测管理专家共识(2025)
Author: Drolma PHURBU ¹ ; Wenjin CHEN ² ; Heng ZHANG ³ ; Jian ZHANG ⁴ ; Xiaomeng WANG ⁵ ; Guoying LIN ¹ ; Wenjun PAN ¹ ; Xiying GUI ¹ ; Xin CAI ¹ ; Chodron TENZIN ¹ ; Jianlei FU ¹ ; Qianwei LI ¹ ; TSEYANG ¹ ; Yijun LIU ¹ ; Bo LIU ¹ ; Tsering DROLMA ¹ ; Yudron SONAM ¹ ; KYILV ⁶ ; Samdrup TSERING ⁷ ; Wa DA ⁸ ; Juan GUO ⁹ ; Cheng QIU ¹⁰ ; Huan CHEN ¹¹ ; Xiaoting WANG ¹² ; Yangong CHAO ¹³ ; Dawei LIU ¹² ; Wenzhao CHAI ¹² ; Chenggong HU ¹⁴ ; Wanhong YIN ¹⁴ ; Shihong ZHU ¹⁵
Author Information

1. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;
2. ICU, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
3. Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang 110121, China;
4. Department of Critical Care Medicine, Shanghai Children's Medical Center, Shanghai 200040, China;
5. Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221000, China;
6. Department of Critical Care Medicine, Shigatse People's Hospital, Shigatse, Tibet 857007, China;
7. Department of Critical Care Medicine, Tibet Autonomous Region Tibetan Hospital, Lhasa 850002, China;
8. Department of Critical Care Medicine, Lhasa People's Hospital, Lhasa 850013, China;
9. Department of Critical Care Medicine, Qamdo People's Hospital, Qamdo, Tibet 854000, China;
10. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;Department of Critical Care Medicine, Nagqu People's Hospital, Nagqu, Tibet 852000, China;
11. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;ICU, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;Guizhou Provincial People's Hospital, Guiyang 550002, China;
12. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
13. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang 110121, China;Department of Critical Care Medicine, The First Affiliated Hospital of Tsinghua University, Beijing 100016, China;
14. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;Department of Critical Care Medicine, Shanghai Children's Medical Center, Shanghai 200040, China;Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;
15. Department of Critical Care Medicine, People's Hospital of Tibet Autonomous Region, Lhasa 850000, China;Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221000, China;Department of Critical Care Medicine, The Seventh Medical Center of PLA General Hospital, Beijing 100700, China;
Collective Name:Consensus on Neurological Care Monitoring and Management-Beijing Tibet Plateau Consensus Group;Consensus on Neurological Care Monitoring and Management-Beijing Tibet Plateau Consensus Writing Group
Publication Type:Journal Article
Keywords: Beijing; Tibet; neurological critical care; monitoring and core management strategies
From: Medical Journal of Peking Union Medical College Hospital 2026;17(1):59-72
CountryChina
Language:Chinese
Abstract:
Neurocritical care involves complex pathophysiological mechanisms, and its incidence is higher, injuries are more severe, and treatment is more challenging in high-altitude environments. This consensus, based on the latest domestic and international evidence-based medical data, establishes a standardized, goal-oriented framework for neurocritical care management applicable in high-altitude regions and nationwide. The consensus was developed following international standards for evidence quality assessment and underwent two rounds of Delphi expert consultation, resulting in 32 recommendation statements covering three parts: management systems, monitoring and assessment, and core strategies. Key updates include: advocating for the establishment of independent neurocritical care units and implementing precise tiered diagnosis and treatment based on the "Five Differences in Critical Care" concept; constructing a "trinity" multimodal brain monitoring system centered on cerebral blood flow, cerebral oxygenation, and brain function, emphasizing routine bedside transcranial Doppler ultrasound, cerebral oximetry, and continuous electroencephalography monitoring; shifting management strategies from mild hypothermia therapy to targeted temperature management, and defining the "446" target management pathway for the supercritical stage; emphasizing the assessment of static and dynamic cerebrovascular autoregulation functions through multimodal methods to achieve individualized optimal mean arterial pressure management; elevating cerebrospinal fluid management goals to the level of "glymphatic system" function maintenance; implementing a multidisciplinary collaborative, whole-process management model focusing on patients' long-term neurological functional outcomes; de-escalation criteria include multidimensional indicators such as recovery of brain structure, restoration of cerebrovascular autoregulation, improvement in cerebrospinal fluid dynamics, and reduction in biomarker levels; and integrating cutting-edge technologies like artificial intelligence into post-critical care management and rehabilitation planning. This consensus systematically integrates the entire process of neurocritical care management, reflecting the modern connotation of goal-oriented, dynamic, and multimodal integration in neurocritical care medicine. It aims to adapt to new trends such as deepening understanding of pathophysiological mechanisms, the integration of medicine and engineering, and the empowerment of artificial intelligence, thereby further advancing the discipline of critical care medicine.