Portable Computed Tomography (CT) studies are an important component used to manage, assess and diagnose CNS diseases, and acute brain injuries, in the Neuroscience ICU (NICU). The portable device is designed specifically for head and neck scans for critically ill patients that are at risk for complications and increased morbidity during intrahospital transportation. Research has found evidence which substantiates that intrahospital transport of patients with brain injuries can impact their outcomes. Many hospital protocols dictate the use of portable head CT (pHCT) scanners to monitor and assess critically ill patients in the NICU, to decrease negative patient outcomes from intrahospital transportation. This is an important factor in reduction and prevention secondary injuries in critically ill patients. The intention of this paper is to critically analyze a research article entitled Portable Head CT Scan and its Effect on Intracranial Pressure (ICP), Cerebral Perfusion Pressure (CPP), and Brain Oxygen. First, there will be an article synopsis identifying the premise of the study. Second, validity of the study will be described and discussed. Lastly, this paper will discuss applicability to Neuroscience ICU at University of New Mexico (UNM) Hospital.
The authors of this research article were from various Departments at University of Pennsylvania in Philadelphia. The researchers conducted a retrospective study to assess possible detrimental association of a pHCT on ICP, CPP, and brain oxygen in patients with severe brain injury. The retrospective study selected 34 patients (16 males and 18 females), with the mean age of 42 (±15 years), and Glasgow Coma Scores (GCS) ≤ 8 at the time of pHCT scan. Patient demographics were as follows: 15 had closed head injuries, 12 had subarachnoid hemorrhage (SAH), 4 had acute subdural hematoma (SDH), 1 with intracerebral hematoma (ICH), 1 gunshot wound, and 1 myocardial infarct (MI). All participants had a pHCT scan completed, and a minimum of 3 hours of brain oxygen monitoring before and after the scan. These patients were all treated at a NICU Level 1 trauma center at the Hospital of the University of Pennsylvania.
The patients were examined using the CereTom portable 8-scale CT scanner by NeuroLogica Corporation, along with continuous inspection of ICP, CPP, and brain tissue oxygenation. This study examined 57 pHCT scans that were administered to 34 patients. The pHCT scans were indicated as part of routine follow-up, postcraniotomy, suspected cerebral edema, altered mental status, post Licox placement/replacement, suspected stroke, suspected intracranial hemorrhage, ventriculostomy placement, seizure, or suspected carotid artery dissection. Patients had continuous intracranial and physiologic monitoring for the following: brain temperature, brain tissue oxygen pressure (PbtO2), heart rate, mean arterial blood pressure, oxygen saturation (SaO2) and ICP. Researchers...