PMID- 27601068
OWN - NLM
STAT- MEDLINE
DCOM- 20171030
LR  - 20220330
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Linking)
VI  - 26
IP  - 1
DP  - 2017 Feb
TI  - Secondary Insults and Adverse Events During Intrahospital Transport of Severe 
      Traumatic Brain-Injured Patients.
PG  - 87-95
LID - 10.1007/s12028-016-0291-5 [doi]
AB  - BACKGROUND: Our aim was to assess the occurrence of secondary insults (SIs) or 
      adverse events (AEs) during intrahospital transport (IHT) of severe traumatic 
      brain injury (TBI) patients for head computed tomography (CT) scanning. METHODS: 
      A prospective study based on severe TBI patients admitted from June 2011 through 
      June 2013 in a level I trauma center. Patients received an IHT to perform a 
      control CT scan in the first 3 days following trauma. The occurrence of SIs and 
      AEs was assessed during the IHT for a control CT scan. The frequency of SIs was 
      compared to the periods "before," "during," and "after" IHT. SI was defined by an 
      intracranial pressure (ICP) >30 mmHg, a cerebral perfusion pressure (CPP) 
      <50 mmHg, systolic blood pressure (SBP) <90 mmHg, or saturation pulse O(2) 
      (SpO(2)) <90 % for more than five consecutive minutes. An AE was defined as 
      failures of hardware or ventilator asynchrony requiring therapeutic intervention 
      during transport. In addition, we assessed the therapeutic benefit of a CT scan 
      control. RESULTS: The final analysis included 31 patients and 31 IHTs. The median 
      duration of IHT was 29 min [25;37]. SIs occurred in 16 patients (52 %) during 
      transport, whereas it was observed in 4 patients (13 %) before (p = 0.002) and 4 
      patients (13 %) after IHT (p = 0.001). Twenty-four AEs occurred during transport 
      of 19 patients (61 %). One patient benefited from hematoma evacuation after 
      implementation of control CT. CONCLUSION: IHT carries significant SIs and AEs in 
      severe TBI patients. To improve a risk/benefit ratio favorable for patients, a 
      program focusing on IHT complications regarding therapeutic impact of control CT 
      scan is needed.
FAU - Martin, Mathieu
AU  - Martin M
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France. mathieu.martin@hmn.aphp.fr.
FAU - Cook, Fabrice
AU  - Cook F
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Lobo, David
AU  - Lobo D
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Vermersch, Charlotte
AU  - Vermersch C
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Attias, Arie
AU  - Attias A
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Ait-Mamar, Bouziane
AU  - Ait-Mamar B
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Plaud, Benoit
AU  - Plaud B
AD  - Department of Anaesthesiology and Surgical Intensive Care, Paris-Diderot 
      University and Assistance-Publique Hopitaux de Paris, St Louis University 
      Hospital, 1 Avenue Claude Vellefaux, 75010, Paris, France.
FAU - Mounier, Roman
AU  - Mounier R
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
FAU - Dhonneur, Gilles
AU  - Dhonneur G
AD  - Surgical Intensive Care Unit - Trauma Center, Department of Anaesthesiology and 
      Critical Care Medicine, Paris-Est Creteil University and Assistance-Publique 
      Hopitaux de Paris, Henri Mondor University Hospital, Avenue du Marechal de Lattre 
      de Tassigny, 94010, Creteil, France.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
SB  - IM
MH  - Adult
MH  - Brain Injuries, Traumatic/*diagnosis/epidemiology/*etiology/therapy
MH  - Female
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - *Neurophysiological Monitoring/statistics & numerical data
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Tomography, X-Ray Computed
MH  - *Transportation of Patients/statistics & numerical data
MH  - *Trauma Centers/statistics & numerical data
MH  - Young Adult
OTO - NOTNLM
OT  - Head computed tomography
OT  - Intrahospital transport
OT  - Traumatic brain injury
EDAT- 2016/09/08 06:00
MHDA- 2017/10/31 06:00
CRDT- 2016/09/08 06:00
PHST- 2016/09/08 06:00 [pubmed]
PHST- 2017/10/31 06:00 [medline]
PHST- 2016/09/08 06:00 [entrez]
AID - 10.1007/s12028-016-0291-5 [pii]
AID - 10.1007/s12028-016-0291-5 [doi]
PST - ppublish
SO  - Neurocrit Care. 2017 Feb;26(1):87-95. doi: 10.1007/s12028-016-0291-5.