OBJECT: Follow-up head CT scans are important in neurocritical care but involve intrahospital transport that may be associated with potential hazards including a deleterious effect on brain tissue oxygen pressure (PbtO(2)). Portable head CT (pHCT) scans offer an alternative imaging technique without a need for patient transport. In this study, the investigators examined the effects of pHCT scans on intracranial pressure (ICP), cerebral perfusion pressure (CPP), and PbtO(2) in patients with severe brain injury. METHODS: Fifty-seven pHCT scans were obtained in 34 patients (mean age of 42 ± 15 years) who underwent continuous ICP, CPP, and PbtO(2) monitoring in the neuro intensive care unit at a university-based Level I trauma center. Patient ICU records were retrospectively reviewed and physiological data obtained during the 3 hours before and after pHCT scans were examined. RESULTS: Before pHCT, the mean ICP and CPP were 14.3 ± 7.4 and 78.9 ± 20.2 mm Hg, respectively. Portable HCT had little effect on ICP (mean ICP 14.1 ± 6.6 mm Hg, p = 0.84) and CPP (mean CPP 81.0 ± 19.8 mm Hg, p = 0.59). The mean PbtO(2) was similar before and after pHCT (33.2 ± 17.0 mm Hg and 31.6 ± 15.9 mm Hg, respectively; p = 0.6). Ten episodes of brain hypoxia (PbtO(2) < 15 mm Hg) were observed before pHCT; these episodes prompted scans. Brain hypoxia persisted in 5 patients after pHCT despite treatment. No new episodes of brain hypoxia were observed during or after pHCT. CONCLUSIONS: These data suggest that pHCT scans do not have a detectable effect on a critically ill patient's ICP, CPP, or PbtO(2).
OBJECT: Follow-up head CT scans are important in neurocritical care but involve intrahospital transport that may be associated with potential hazards including a deleterious effect on brain tissue oxygen pressure (PbtO(2)). Portable head CT (pHCT) scans offer an alternative imaging technique without a need for patient transport. In this study, the investigators examined the effects of pHCT scans on intracranial pressure (ICP), cerebral perfusion pressure (CPP), and PbtO(2) in patients with severe brain injury. METHODS: Fifty-seven pHCT scans were obtained in 34 patients (mean age of 42 ± 15 years) who underwent continuous ICP, CPP, and PbtO(2) monitoring in the neuro intensive care unit at a university-based Level I trauma center. Patient ICU records were retrospectively reviewed and physiological data obtained during the 3 hours before and after pHCT scans were examined. RESULTS: Before pHCT, the mean ICP and CPP were 14.3 ± 7.4 and 78.9 ± 20.2 mm Hg, respectively. Portable HCT had little effect on ICP (mean ICP 14.1 ± 6.6 mm Hg, p = 0.84) and CPP (mean CPP 81.0 ± 19.8 mm Hg, p = 0.59). The mean PbtO(2) was similar before and after pHCT (33.2 ± 17.0 mm Hg and 31.6 ± 15.9 mm Hg, respectively; p = 0.6). Ten episodes of brain hypoxia (PbtO(2) < 15 mm Hg) were observed before pHCT; these episodes prompted scans. Brain hypoxia persisted in 5 patients after pHCT despite treatment. No new episodes of brain hypoxia were observed during or after pHCT. CONCLUSIONS: These data suggest that pHCT scans do not have a detectable effect on a critically ill patient's ICP, CPP, or PbtO(2).
Authors: Mercy H Mazurek; Bradley A Cahn; Matthew M Yuen; Anjali M Prabhat; Isha R Chavva; Jill T Shah; Anna L Crawford; E Brian Welch; Jonathan Rothberg; Laura Sacolick; Michael Poole; Charles Wira; Charles C Matouk; Adrienne Ward; Nona Timario; Audrey Leasure; Rachel Beekman; Teng J Peng; Jens Witsch; Joseph P Antonios; Guido J Falcone; Kevin T Gobeske; Nils Petersen; Joseph Schindler; Lauren Sansing; Emily J Gilmore; David Y Hwang; Jennifer A Kim; Ajay Malhotra; Gordon Sze; Matthew S Rosen; W Taylor Kimberly; Kevin N Sheth Journal: Nat Commun Date: 2021-08-25 Impact factor: 14.919
Authors: Kevin N Sheth; Mercy H Mazurek; Matthew M Yuen; Bradley A Cahn; Jill T Shah; Adrienne Ward; Jennifer A Kim; Emily J Gilmore; Guido J Falcone; Nils Petersen; Kevin T Gobeske; Firas Kaddouh; David Y Hwang; Joseph Schindler; Lauren Sansing; Charles Matouk; Jonathan Rothberg; Gordon Sze; Jonathan Siner; Matthew S Rosen; Serena Spudich; W Taylor Kimberly Journal: JAMA Neurol Date: 2020-09-08 Impact factor: 29.907
Authors: Patrick H Knight; Neelabh Maheshwari; Jafar Hussain; Michael Scholl; Michael Hughes; Thomas J Papadimos; Weidun Alan Guo; James Cipolla; Stanislaw P Stawicki; Nicholas Latchana Journal: Int J Crit Illn Inj Sci Date: 2015 Oct-Dec
Authors: Anjali M Prabhat; Anna L Crawford; Mercy H Mazurek; Matthew M Yuen; Isha R Chavva; Adrienne Ward; William V Hofmann; Nona Timario; Stephanie R Qualls; Juliana Helland; Charles Wira; Gordon Sze; Matthew S Rosen; William Taylor Kimberly; Kevin N Sheth Journal: Front Neurol Date: 2021-12-10 Impact factor: 4.003