PAEDIATRIC NEURO CRITICAL CARE NAVIGATING CHALLENGES AND OPPORTUNITIES

Paediatric neurocritical care is a rapidly evolving field aimed at managing critically ill children with severe neurological conditions such as traumatic brain injury (TBI), hypoxic-ischemic encephalopathy (HIE), status epilepticus, and central nervous system (CNS) infections. These conditions are significant contributors to childhood morbidity and mortality, particularly in low- and middle-income countries (LMICs) like Pakistan, where healthcare resources are limited. This review examines the current challenges and opportunities in paediatric neurocritical care, with a focus on improving outcomes in resource-limited settings. Methods: This review synthesizes recent research (2014-2024) on the pathophysiology, risk factors, early diagnostic tools, and treatment strategies for paediatric neurocritical conditions. It highlights the role of multidisciplinary care and long-term rehabilitation while addressing the challenges faced in LMICs, including healthcare infrastructure limitations, shortage of specialized professionals, and socio-economic barriers. Emerging therapies, including neuroprotective strategies, and innovations such as artificial intelligence (AI) and telemedicine, are explored. Results: Paediatric neurocritical care in Pakistan faces significant challenges due to delays in diagnosis, limited access to advanced diagnostics, and a shortage of specialized healthcare providers. Multidisciplinary care and family-centred care have improved outcomes in tertiary care centres, but rural areas remain underserved. Recent advances in neuroprotective therapies, AI, and telemedicine show promise in addressing these challenges, but further research and infrastructure development are needed to make these solutions widely accessible. Conclusion: Paediatric neurocritical care presents both challenges and opportunities, particularly in LMICs like Pakistan. While emerging therapies and technological innovations offer hope for improving care, significant efforts are needed to address healthcare disparities and expand access to neurocritical care services. Strengthening healthcare infrastructure, developing local expertise, and investing in international collaborations will be key to navigating the challenges and enhancing neurocritical care outcomes for children globally.