Patient Care

UR Medicine Opens Doors on New Neuromedicine ICU

Jul. 27, 2014

UR Medicine today unveiled a new state-of-the-art unit dedicated to highly specialized care for people with serious and life-threatening neurological conditions, like strokes, seizures, brain and spinal tumors, and traumatic brain injury. The Neuromedicine Intensive Care Unit (ICU), which is the only unit of its kind in the region, is located on the eighth floor of Strong Memorial Hospital.

The $5.5 million, 5,500-square-foot unit consists of 12 beds and is staffed around the clock by an extended multidisciplinary team trained to treat the most challenging and difficult neurological disorders. The neurocritical care team members include neurointensivists, neurologists, neurosurgeons, physician assistants, nurse practitioners, critical care nurses, anesthesiologists, respiratory therapists, social workers, physical therapists, speech-language pathologists, occupational therapists, nutritionists, and clinical pharmacologists.

Diseases and injuries that impact the brain and central nervous system have a unique set of challenges and require expertise that is not commonly found in a traditional ICU setting. While brain function must be continuously monitored, providers also need to be trained to recognize that these conditions can potentially lead to other problems, such as cardiovascular, kidney, and respiratory complications or infections, particularly if a patient remains in an ICU setting for a long period of time. Also, once a patient has been stabilized, there must be continuity of care as they begin the process of recovery and transition to rehabilitation.

Last year, UR Medicine recruited two physicians with the extensive training and unique skills necessary to operate this new program. Neurologist Manjunath Markandaya, M.D., M.B.B.S., is the medical director of the Neuromedicine ICU. He joined UR Medicine from R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center. Prior to that, he was a staff physician in the Cleveland Clinic Neurologic ICU and received his fellowship training at Johns Hopkins University and the University of Maryland.

Amrendra Singh Miranpuri, M.D. – the surgical co-director of the Neuromedicine ICU – specializes in open and interventional neurosurgical procedures for cerebrovascular disease like stroke. He received his training at the University of Wisconsin and the Medical University of South Carolina.

“Acute neurological conditions like stroke and traumatic brain injury can be some of the most complex diseases to treat in medicine,” said Markandaya. “They require an aggressive course of treatment that, while it is focused on brain recovery, also recognizes that these injuries often impact and pose risks for other systems in the body.”

The new unit was designed with the recognition that not only does it need to bring together the technology and expertise to treat the sickest patients, but it also must place their families at the center of care. The rooms are large enough to accommodate family members who want to stay with their loved ones throughout the length of their stay. Also, family members are encouraged to be active participants in decisions related to the course of care, often joining the care team as they discuss treatment options.

“Families play an essential role in the care and recovery of people suffering from acute neurological conditions,” said Miranpuri. “They can pick up on things and they understand the needs of the patient, who often is not in a position to speak on their own behalf.”

The new unit is one of the centerpieces of the UR Medicine Comprehensive Stroke Center. Strong Memorial Hospital is only one of three hospitals in New York State and the only one in the region that has been certified by the Joint Commission as having the dedicated 24-hour acute care teams and critical care programs necessary to treat the most complicated stroke cases.

The Neurocritical Care Program was created in October 2013 and since that time has occupied eight beds in the Kessler Burn Trauma Center at Strong Memorial Hospital. Patients will be treated in the new unit effective July 29.

“Patients who suffer a stroke and other acute neurological conditions deserve the highest level of coordinated, comprehensive, and technology driven care,” said Webster H. Pilcher, M.D., Ph.D., chair of the Neurosurgery Department. “The Neuromedicine ICU is the next evolution in our efforts to provide patients throughout the region with access to care that will increase survival and improve quality of life.”

“This new unit and our commitment to neurocritical care will ensure that we are providing the highest level of care to individuals with grave and life-threatening neurological conditions,” said Robert Holloway, M.D., M.P.H., chair of the Neurology Department. “These efforts will also enable us to devise new and better ways to help patients and their families overcome these devastating diseases.”