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在法国 ICU 中对严重急性脑损伤患者实施便携式头部 CT 成像:一项前瞻性前后设计的试点研究。

Implementation of portable head CT imaging in patients with severe acute brain injury in a French ICU: a prospective before-after design pilot study.

机构信息

Critical Care Unit, Department of Anaesthesia, Critical Care and Perioperative Medicine, Centre Hospitalier Universitaire de Rennes, 2 Rue Henri Le Guilloux, 35033, Rennes, France.

University of Rennes, 2, Rue Henri Le Guilloux, 35033, Rennes, France.

出版信息

Sci Rep. 2022 Dec 2;12(1):20846. doi: 10.1038/s41598-022-25263-6.

Abstract

Head-CT-scanning is a cornerstone procedure during the management of patients admitted for acute brain injury (ABI) in intensive care unit (ICU). But intrahospital transfer for these procedure is known to increase the rate of severe adverse events potentially worsening the brain injuries. Portable head-CT (pCTH) may facilitate pCTH performance in safer conditions for the patients avoiding transfer out of the ICU. To evaluate the safety and the time duration required to use a portable head CT (pCTH) scanner in the intensive care unit (ICU) in the French healthcare system in ICU patients admitted for acute brain injury, we prospectively included all ICU-patients admitted for severe ABI over a 2-year period following before-after design. As the main outcome, we compared the time required to perform a scan with pCTH to that with conventional head CT (cCTH) and reported adverse events and reactions. In total, forty-six patients were included and finally, 41 patients were analyzed (21 in the pCTH group and 20 in the cCTH group). The median (interquartile) time required to perform a scan with pCTH was 28 (23-48) minutes compared to 30 (25-36) minutes with cCTH (p = 0.825). The duration time required to perform a pCTH was similar to that with cCTH in an ICU of the French healthcare system without significant difference in adverse events reactions.

摘要

在重症监护病房(ICU)中,对急性脑损伤(ABI)患者进行管理时,头部 CT 扫描是一项重要的程序。但是,众所周知,由于该程序需要在医院内部进行转移,因此会增加严重不良事件的发生率,从而可能使脑损伤恶化。便携式头部 CT(pCTH)可以在对患者更安全的条件下进行 pCTH 检查,从而避免将患者转出 ICU。为了评估在法国医疗保健系统的 ICU 中,便携式头部 CT(pCTH)扫描仪在 ICU 中用于急性脑损伤患者的安全性和所需时间,我们采用前瞻性设计,在 2 年期间,连续纳入了所有因严重 ABI 而被收入 ICU 的患者。主要结局是,我们比较了使用 pCTH 进行扫描所需的时间与使用常规头部 CT(cCTH)进行扫描所需的时间,并报告了不良事件和反应。总共纳入了 46 名患者,最终对 41 名患者进行了分析(pCTH 组 21 名,cCTH 组 20 名)。与 cCTH 相比,使用 pCTH 进行扫描的中位数(四分位距)时间为 28(23-48)分钟,而 cCTH 为 30(25-36)分钟(p=0.825)。在法国医疗保健系统的 ICU 中,进行 pCTH 的时间与 cCTH 相似,不良事件反应无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c73/9718813/cbe89eda1130/41598_2022_25263_Fig1_HTML.jpg

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