Blog Viewer

The Impact of Intrahospital Transports on Brain Tissue Metabolism in Patients with Acute Brain Injury

By Currents Editor posted 02-11-2019 14:24


By Jan Küchler, Franziska Tronnier, Emma Smith, Jan Gliemroth, Volker M. Tronnier, Claudia Ditz


Patients with severe acute brain injury (ABI) often require intrahospital transports (IHTs) for repeated computed tomography (CT) scans. IHTs are associated with serious adverse events (AE) that might pose a risk for secondary brain injury. The goal of this study was to assess IHT-related alterations of cerebral metabolism in ABI patients.


We included mechanically ventilated patients with ABI who had continuous multimodality neuromonitoring during an 8-h period before and after routine IHT. Intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain tissue oxygenation (PtiO2) as well as cerebral and subcutaneous microdialysis parameters (lactate, pyruvate, glycerol, and glutamate) were recorded. Values were compared between an 8-h period before (pre-IHT) and after (post-IHT) the IHT.


A total of 23 IHT for head CT scans in 18 patients were analyzed. Traumatic brain injury (n = 7) was the leading cause of ABI, followed by subarachnoid hemorrhage (n = 6) and intracerebral hemorrhage (n = 5). The analyzed microdialysis parameters in the brain tissue as in the subcutaneous tissue did not show significant changes between the pre-IHT and post-IHT period. In addition, we observed no significant increase in ICP or decrease in CPP and PtiO2 in the 8-h period after IHT.


While the occurrence of AE during IHT is a known risk factor for ABI patients, our results demonstrate that IHTs do not alter the brain tissue chemistry in a significant manner. This fact may help assess the risk for routine IHT more accurately.

Read more


By Roy Poblete, MD, David Seder, MD, Gene Sung, MD     Since the first Emergency Neurologic Life Support (ENLS) course, there has always been a great deal of interest in developing an advanced learning follow-up course. The Neurocritical Care Society is now proud to present the brand-new ...
The Currents Editorial Board is seeking Stories of Hope submissions for 2020. Stories of Hope tells the stories of patients who have fought their way to recovery and the experiences of their family and/or medical providers. By sharing these stories, we remind each other of what we are all working ...
By Pouya Alexander Ameli, MD, MS Neurocritical Care Fellow, Emory University Chair-Elect, Trainee Section   Naomi Niznick, MD PGY3 Neurology Resident, The Ottawa Hospital Trainee Section Leadership Committee     In Homer’s The Odyssey , Odysseus asks for his friend “Mentor” to watch ...