title: Routine follow-up cranial computed tomography for deeply sedated, intubated, and ventilated multiple trauma patients with suspected severe head injury.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Thomas Erik
authors.identifier: 0000-0001-7246-3846
authors.initials: TE
authors.lastname: Wurmb
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schlereth
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Markus
authors.identifier: 0000-0003-2183-033X
authors.initials: M
authors.lastname: Kredel
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Ralf M
authors.initials: RM
authors.lastname: Muellenbach
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Christian
authors.identifier: 0000-0002-0871-0395
authors.initials: C
authors.lastname: Wunder
authors.affiliation: Department of Intensive Care Medicine, HELIOS Klinikum Berlin-Buch Schwanebecker Chaussee 50, 13125 Berlin, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Brederlau
authors.affiliation: Department of Anaesthesiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Norbert
authors.identifier: 0000-0002-8329-9049
authors.initials: N
authors.lastname: Roewer
authors.affiliation: Department of Radiology, University Hospital of Wuerzburg, Oberduerrbacher Straße 6, 97080 Wuerzburg, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Kenn
authors.affiliation: Department of Neurosurgery, University Hospital of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany.
authors.forename: Ekkehard
authors.identifier: 0000-0002-5897-4348
authors.initials: E
authors.lastname: Kunze
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D054810:Deep Sedation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000473:pathology; D012123:Pulmonary Ventilation; D012886:Skull / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome