Routine follow-up cranial computed tomography for deeply sedated, intubated, and ventilated multiple trauma patients with suspected severe head injury

Biomed Res Int. 2014:2014:361949. doi: 10.1155/2014/361949. Epub 2014 Jan 20.

Abstract

Background: Missed or delayed detection of progressive neuronal damage after traumatic brain injury (TBI) may have negative impact on the outcome. We investigated whether routine follow-up CT is beneficial in sedated and mechanically ventilated trauma patients.

Methods: The study design is a retrospective chart review. A routine follow-up cCT was performed 6 hours after the admission scan. We defined 2 groups of patients, group I: patients with equal or recurrent pathologies and group II: patients with new findings or progression of known pathologies.

Results: A progression of intracranial injury was found in 63 patients (42%) and 18 patients (12%) had new findings in cCT 2 (group II). In group II a change in therapy was found in 44 out of 81 patients (54%). 55 patients with progression or new findings on the second cCT had no clinical signs of neurological deterioration. Of those 24 patients (44%) had therapeutic consequences due to the results of the follow-up cCT.

Conclusion: We found new diagnosis or progression of intracranial pathology in 54% of the patients. In 54% of patients with new findings and progression of pathology, therapy was changed due to the results of follow-up cCT. In trauma patients who are sedated and ventilated for different reasons a routine follow-up CT is beneficial.

MeSH terms

  • Adult
  • Brain Injuries / diagnostic imaging*
  • Brain Injuries / pathology
  • Deep Sedation*
  • Female
  • Follow-Up Studies
  • Humans
  • Intubation*
  • Male
  • Multiple Trauma / diagnostic imaging*
  • Multiple Trauma / pathology
  • Pulmonary Ventilation*
  • Skull / diagnostic imaging*
  • Skull / pathology
  • Tomography, X-Ray Computed*
  • Treatment Outcome