Wed. Sep 22nd, 2021

Yasser B. Abulhasan, MBChB, FRCPC, FNCS, Chairman, Neurocritical Care-MENA Chapter of IPACCMS

It was a great pleasure organizing the 2nd Neurocritical Care Regional Meeting in the Middle East and Africa in conjunction with the 17th edition of the Emirates Critical Care Conference (ECCC). The meeting got delayed by more than a year due to the COVID-19 pandemic, ultimately taking place in a hybrid format (both in person and virtual) on June 18 and 19, 2021.

This was a challenging yet exciting event from the start. We wanted to exceed expectations after the success of the First Regional Meeting. But after finalizing the scientific content, speakers, workshops, venue, and logistics of holding the meeting on April 2-4, 2020, the spread of a new coronavirus causing a mysterious pneumonia was announced by the World Health Organization a few weeks before the event. The early reports were alarming and anticipated a pandemic, which forced us to delay the meeting in unprecedented fashion. We were among the first international critical care conferences to do so as the conference was only weeks away, a decision that was tough but ultimately correct, especially in the early phases of an unknown, transmissible, potentially fatal disease.

After hearing from the organizing committee in Dubai, I remember announcing this postponement in person during the Neurocritical Care Society (NCS) Board of Directors’ meeting in Chicago on March 10, 2020. This was followed by side discussions with other members of the NCS Board of Directors on early reports of this ‘puzzling’ entity and its pathophysiology. I doubt anyone then would have anticipated the events that unfolded and caused a global standstill within days of the World Health Organization’s global pandemic declaration.

In the ensuing days and weeks, we had an open dialogue with the Editor-in-Chief of Neurocritical Care on when to best publish accepted abstracts (which would usually coincide with the actual conference dates), while debating how such a delay in publication of accepted scientific work would translate to authors. Ultimately, the Regional Meeting was further postponed until June 18-19, 2021, in order to accommodate the Hybrid Emirates Critical Care Conference Series, which I am proud to say that NCS actively participated in. This single-track lecture series took place on November 14, 28, and December 12, 2020. It was the first experience in organizing a hybrid conference dedicated towards COVID-19 in the region.

As part of the COVID-19 hybrid conference series, the neurocritical care session took place on November 28, 2020, with 5 pre-recorded talks: (1) Cerebrovascular Complications of COVID-19, (2) Non-Vascular Neurological Manifestations of COVID-19, (3) Neurocritical Care in the Era of the COVID-19 Pandemic: Abu Dhabi’s Experience, (4) Crisis Management during the COVID-19 Pandemic, and (5) Research in Neurocritical Care during the COVID-19 Pandemic. There were over 1000 virtual attendees at the neurocritical care session (and over 1700 for the day overall), and the live Q&A session was a huge success, with kudos to all speakers and attendees who joined worldwide. This success was the driving force behind the decision to proceed with the Second Regional Meeting in a hybrid format.

This time around, the experience felt different. The few months leading up to the meeting were unique, as the multiple waves of the SARS-CoV-2 pandemic revealed the vulnerability of most healthcare workers worldwide. Colleagues and loved ones suffered from the sequelae of the pandemic physically and mentally, and by then more than 3 million deaths worldwide had been attributed to COVID-19. Offline, healthcare workers expressed fatigue from virtual conferences and meetings. Still, we aimed to defy these challenges and actively enter a ‘partially normal’ phase of living for healthcare workers by moving forward with the Regional Meeting in a 2-day hybrid format instead of the original 3-day in person meeting. This was done in conjunction with the multitrack ECCC and 16th World Federation of Critical Care Nurses (WFCCN) World Congress.

On day 1, the full-day, multidisciplinary, neurocritical care track was divided into 4 sessions: (1) practice updates in neurocritical care, (2) neuro-nursing and neuropharmacology, (3) a pros-and-cons session, and (4) a subarachnoid hemorrhage expert’s discussion. Presentation topics covered a selected spectrum of neurocritical care topics. Topics included updates on the UAE guideline on declaration of death by neurological criteria, thrombectomy after acute ischemic stroke up to 24 hours and beyond, neurological complications after COVID-19, gizmos and gadgets in the neuro-ICU, reversal of anticoagulation, and neuro-mediated pathophysiological stresses affecting the nervous and cardio-respiratory systems. Conducting a hybrid pros-and-cons session proved to be technically challenging, as we expected a swift ‘hybrid’ vote after each debate (i.e., combined vote counts from in person and virtual audiences). However, the speakers stood up to the challenge and contributed to spirited debates. The SAH expert discussion, meanwhile, included presentations on current evidence-based practice, the use of milrinone after DCI, and updates on SAH research. All of these were met with great enthusiasm and were followed by an informative 20+ minutes Q&A session with the experts.

Day 2 included hybrid poster presentations and a full-day ENLS hybrid course, for which NCS graciously offered 100 free registrations preferentially to nurses and pharmacists attending the meeting. Of note, a number of abstracts presented at the meeting had to be withdrawn from the Neurocritical Care publication due to copyright reasons, as many were published in full elsewhere during the prolonged delay between scientific abstract acceptance and publication. The remaining abstracts were published online in Neurocritical Care shortly after the meeting.

Overall, the conference was attended by over 1000 delegates (both in person and virtually). Of the 198 speakers (almost evenly split between in person and virtual), 48% were international, 34% local, and 18% regional, representing a total of 45 countries. There were 5 workshops including ENLS, 3 of which were hands-on, with appropriate social distancing and safety measures to reduce the spread of COVID-19.

Acknowledgements
I would like to acknowledge the partnership between the International Pan Arab Critical Care Medicine Society (IPACCMS) and NCS, especially the role of leadership from both societies in making this meeting a reality. Additionally, I would like to acknowledge the voluntary efforts of our esteemed group of speakers and moderators from both the Neuro-COVID-19 session and Regional Meeting, and sincerely thank them for their role during these meetings.

Neuro-COVID-19 and beyond session of the Hybrid Emirates Critical Care Conference (November 28, 2020) speakers and moderators (virtual): Yasser Abulhasan, Mary Kay Bader, Sherry Chou, Jamil Dibu, Majid Mokhtari, Jose Suarez, Katja Wartenberg.

Regional Meeting (June 18-19, 2020) track/ENLS speakers and moderators (in person and virtual): Yasser Abulhasan, Pravin Amin, Mark Angle, Aimee Aysenne, Hosam Al-Jehani, Mary Kay Bader, Gretchen Brophy, Jamil Dibu, Michael Diringer, Saef Izzy, Farah Kablaoui, Kalpana Krishnareddy, Sarah Livesay, George Lopez, Dea Mahanes, Majid Mokhtari, Sarah Peacock, Venkatakrishna Rajajee, Gisele Sampaio Silva, Othman Solaiman, Jose Suarez, Michel Torbey, Chitra Venkatasubramanian, Katja Wartenberg and Khalil Yousef. Additionally, I would like to acknowledge Ramy Satti, and Hasan Hadad for coordinating the NCC track, and Katja Wartenberg for directing the ENLS course. Sincere thanks go to Hussain Al Rahma (conference chairman) and team, and Katja Wartenberg for co-organizing this meeting.

Overall, despite this unprecedented pandemic year, the partnership between the IPACCMS and NCS remained strong with the active support and participation of all involved. Critical Care representation of neurosciences in our regional remains vital.

Global Partnership Milestones
Since 2011, the NCC-MENA chapter of IPACCMS has been one of the first global partners of NCS. NCS leadership has been invited to sit during the open annual NCC-MENA chapter meeting. Over the years, the neurocritical care track of the ECCC has continued to grow. ENLS was first offered in 2016, then in 2018, 2019 (in person), and 2021 (hybrid). In October 2018, NCS confirmed the first Mid-East/Africa member to represent the region on its Board of Directors. In April 2019, the 1st NCC Middle East/Africa Regional Meeting was conducted in person in Dubai, and in June 2021, the hybrid format 2nd Regional Meeting was conducted in conjunction with the 15th and 17th edition of the ECCC.

For now, if things stay on track, save the date for May 12-14, 2022, when we will look forward to welcoming you all in Dubai for the 3rd Neurocritical Care Regional Meeting of the Middle East/Africa.

By A.S.R

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