INHOSPITAL TRANSPORT OF PATIENTS IN ACUTE PERIOD OF SEVERE ISOLATED TRAUMATIC BRAIN INJURY WITH MULTIMODAL MONITORING

• Published in: Anesteziologiia i reanimatologiia Vol. 61; no. 2; p. 100
• Main Authors: Matskovskiy, I V, Polupan, A A, Savin, I A, Goryachev, A S, Oshorav, A V, Sychev, A A, Krylav, K Yu, Anan'ev, E P
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01-03-2016
• Subjects: Adult; Brain Injuries, Traumatic - diagnostic imaging; Brain Injuries, Traumatic - nursing; Brain Injuries, Traumatic - physiopathology; Brain Injuries, Traumatic - surgery; Female; Glasgow Coma Scale; Humans; Intensive Care Units; Intracranial Pressure - physiology; Male; Middle Aged; Monitoring, Physiologic; Tomography, X-Ray Computed; Transportation of Patients - methods; Treatment Outcome
• ISSN: 0201-7563

Transporting patients out of intensive care unit (ICU) in the acute period of TBI to perform diagnostic tests is an integral part of the treatment process and may be associated with the risk of secondary brain injury. Despite the large number of studies related to in-hospital transport ofpatients with TBI there are no clear recommendations on the required monitoring.
To provide safe transportation of the patient by multimodal monitoring in acute period of brain injury.
The study included 9 patients with severe TBI and loss of consciousness (Glasgow coma scale (GCS) 8 or less). The average GCS score was 5.5. The median age was 31 +/- 12 (21 to 54 years). There were 2 women and 7 men. Duration of the transportation was 52 +/- 7,4 min. Data collection was carried out every minute. All patients during transportation were monitoredfor the following parameters: HR, invasive ABP, ICE CPP EtCO2, SpO2. Before and immediately after the transportation sampling of arterial blood was performed for blood gas analysis.
Statistically significant differences in ICP was noted in 5 main items (*p < 0.05). Mean ICP was mentioned in bed (12.5 +/- 5.3), on wheelchair (18.2 +/- 6.8*), in CT-scan (16.6 +/- 3.2**), on wheelchair after scan (18.4 +/- 4.1***), in bed again (15.8 +/- 2.9). Other parameters didn't differ significantly.
Multimodal monitoring enables safe transportation ofpatients in acute period of TBI. There are 5 critical items associated with major complication during transportation (original ICE shifting patient from bed to transport wheelchair from wheelchair to CT-scanner table, from CT-scanner table to transport wheelchair from wheelchair to bed). The most unstable parameter is ICP