naa a22 4500 510800165 CHVBK 20180411083351.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12028-012-9802-1 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9802-1 Intra-hospital Transport of Brain-Injured Patients: A Prospective, Observational Study [Elektronische Daten] [Edoardo Picetti, Marta Antonini, Maria Lucchetti, Serena Pucciarelli, Adriana Valente, Ilaria Rossi, Paolo Schiavi, Franco Servadei, Maria Caspani, Mario Mergoni] Introduction: Discrepant data exist regarding the incidence and severity of clinical problems related to intra-hospital transport of brain-injured patients and no consensus exists whether modern-day intra-hospital transport represents a safe or potentially problematic environment for neurointensive care unit (NICU) patients. Methods: We examined the incidence of clinical complications and physiological derangements that occurred in 160 neurologically injured patients (90 males, 70 females, mean age 57±17years) who underwent intra-hospital transport (288 cases, 237 scheduled, 51 unscheduled) for computed tomography scans. Results: Our findings indicate that (1) at least one significant complication (predominantly hemodynamic) occurred in over one-third (36%) of all transports (p=n.s scheduled vs. unscheduled) necessitating the deployment of interventions designed to treat changes in arterial pressure (2) despite the presence of trained medical personnel and availability of specialized equipment, intra-cranial pressure was not adequately monitored during transports (especially in patients with intra-cranial hypertension prior to transport) (3) intra-hospital transfer was associated with minor but statistically significant clinical changes, including a reduction in arterial partial pressure of oxygen ( $$ {\text{Pa}}_{{{\text{O}}_{ 2} }} $$ )/inspired oxygen fraction ( $$ {\text{Fi}}_{{{\text{O}}_{ 2} }} $$ ) (only in the scheduled transport population), decreased arterial lactate levels (scheduled transport population), lowered body temperature (scheduled transport population), and increased arterial partial pressure of carbon dioxide ( $$ {\text{Pa}}_{{{\text{CO}}_{ 2} }} $$ ) (scheduled transport population). Conclusions: Intra-hospital transport of brain-injured NICU patients may present some hazards even if performed by skilled personnel with specialized equipment. In Trauma Centers such as ours, an improvement in the frequency of neuromonitoring [intra-cranial pressure (ICP) and end-tidal CO2 ( $$ {\text{ET}}_{{{\text{CO}}_{ 2} }} $$ )] during transport is recommended. Springer Science+Business Media New York, 2012 Intra-hospital transport nationallicence Traumatic brain injury nationallicence Intensive care nationallicence Neurocritical care nationallicence Complications nationallicence Monitoring nationallicence Picetti Edoardo I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut Antonini Marta I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut Lucchetti Maria Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut Pucciarelli Serena Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut Valente Adriana Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut Rossi Ilaria I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut Schiavi Paolo Neurochirurgia e Neurotraumatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy aut Servadei Franco Neurochirurgia e Neurotraumatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy aut Caspani Maria I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut Mergoni Mario I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut Neurocritical Care Humana Press Inc 18/3(2013-06-01), 298-304 1541-6933 18:3<298 2013 18 12028 https://doi.org/10.1007/s12028-012-9802-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9802-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Picetti Edoardo I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Antonini Marta I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Lucchetti Maria Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut NATIONALLICENCE 700 1- Pucciarelli Serena Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut NATIONALLICENCE 700 1- Valente Adriana Scuola di Specializzazione in Anestesia e Rianimazione, Università degli Studi di Parma, Parma, Italy aut NATIONALLICENCE 700 1- Rossi Ilaria I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Schiavi Paolo Neurochirurgia e Neurotraumatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy aut NATIONALLICENCE 700 1- Servadei Franco Neurochirurgia e Neurotraumatologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy aut NATIONALLICENCE 700 1- Caspani Maria I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 700 1- Mergoni Mario I Servizio Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/3(2013-06-01), 298-304 1541-6933 18:3<298 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer