BACKGROUND: Patients with severe acute brain injury (ABI) often require intrahospital transports (IHTs) for repeated computed tomography (CT) scans. IHTs are associated with serious adverse events (AE) that might pose a risk for secondary brain injury. The goal of this study was to assess IHT-related alterations of cerebral metabolism in ABI patients. METHODS: We included mechanically ventilated patients with ABI who had continuous multimodality neuromonitoring during an 8-h period before and after routine IHT. Intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain tissue oxygenation (PtiO2) as well as cerebral and subcutaneous microdialysis parameters (lactate, pyruvate, glycerol, and glutamate) were recorded. Values were compared between an 8-h period before (pre-IHT) and after (post-IHT) the IHT. RESULTS: A total of 23 IHT for head CT scans in 18 patients were analyzed. Traumatic brain injury (n = 7) was the leading cause of ABI, followed by subarachnoid hemorrhage (n = 6) and intracerebral hemorrhage (n = 5). The analyzed microdialysis parameters in the brain tissue as in the subcutaneous tissue did not show significant changes between the pre-IHT and post-IHT period. In addition, we observed no significant increase in ICP or decrease in CPP and PtiO2 in the 8-h period after IHT. CONCLUSIONS: While the occurrence of AE during IHT is a known risk factor for ABI patients, our results demonstrate that IHTs do not alter the brain tissue chemistry in a significant manner. This fact may help assess the risk for routine IHT more accurately.
BACKGROUND:Patients with severe acute brain injury (ABI) often require intrahospital transports (IHTs) for repeated computed tomography (CT) scans. IHTs are associated with serious adverse events (AE) that might pose a risk for secondary brain injury. The goal of this study was to assess IHT-related alterations of cerebral metabolism in ABI patients. METHODS: We included mechanically ventilated patients with ABI who had continuous multimodality neuromonitoring during an 8-h period before and after routine IHT. Intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain tissue oxygenation (PtiO2) as well as cerebral and subcutaneous microdialysis parameters (lactate, pyruvate, glycerol, and glutamate) were recorded. Values were compared between an 8-h period before (pre-IHT) and after (post-IHT) the IHT. RESULTS: A total of 23 IHT for head CT scans in 18 patients were analyzed. Traumatic brain injury (n = 7) was the leading cause of ABI, followed by subarachnoid hemorrhage (n = 6) and intracerebral hemorrhage (n = 5). The analyzed microdialysis parameters in the brain tissue as in the subcutaneous tissue did not show significant changes between the pre-IHT and post-IHT period. In addition, we observed no significant increase in ICP or decrease in CPP and PtiO2 in the 8-h period after IHT. CONCLUSIONS: While the occurrence of AE during IHT is a known risk factor for ABI patients, our results demonstrate that IHTs do not alter the brain tissue chemistry in a significant manner. This fact may help assess the risk for routine IHT more accurately.
Authors: Anne L Donovan; J Matthew Aldrich; A Kendall Gross; Denise M Barchas; Kevin C Thornton; Hildy M Schell-Chaple; Michael A Gropper; Angela K M Lipshutz Journal: Crit Care Med Date: 2018-06 Impact factor: 7.598
Authors: Seby John; Sarah Stock; Russell Cerejo; Ken Uchino; Stacey Winners; Andrew Russman; Thomas Masaryk; Peter Rasmussen; Muhammad S Hussain Journal: J Neuroimaging Date: 2015-11-23 Impact factor: 2.486
Authors: Carlos V R Brown; Gabriel Zada; Ali Salim; Kenji Inaba; Georgios Kasotakis; Pantelis Hadjizacharia; Demetrios Demetriades; Peter Rhee Journal: J Trauma Date: 2007-06
Authors: Ivan Timofeev; Keri L H Carpenter; Jürgens Nortje; Pippa G Al-Rawi; Mark T O'Connell; Marek Czosnyka; Peter Smielewski; John D Pickard; David K Menon; Peter J Kirkpatrick; Arun K Gupta; Peter J Hutchinson Journal: Brain Date: 2011-01-18 Impact factor: 13.501
Authors: Nudrat Tasneem; Edgar A Samaniego; Connie Pieper; Enrique C Leira; Harold P Adams; David Hasan; Santiago Ortega-Gutierrez Journal: Crit Care Res Pract Date: 2017-05-07