Portable head CT scan and its effect on intracranial pressure, cerebral perfusion pressure, and brain oxygen: Clinical article

Kaitlin Peace, Eileen Maloney-Wilensky, Suzanne Frangos, Marianne Hujcs, Joshua Levine, W. Andrew Kofke, Wei Yang, Peter D. Le Roux

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

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 PbtO2 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 PbtO2 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 PbtO2 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 (PbtO2 < 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 PbtO2.

Original languageEnglish (US)
Pages (from-to)1479-1484
Number of pages6
JournalJournal of neurosurgery
Volume114
Issue number5
DOIs
StatePublished - May 2011

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this