title: Intrahospital Transfer of Patients with Traumatic Brain Injury: Increase in Intracranial Pressure.
abstract: To assess the dynamic of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and dynamic pressure reactivity index (PRx) during intrahospital transport.
  
  
  
  There were 33 comatose patients with severe traumatic brain injury (TBI). The mean age was 36.3 ± 4.8 years (range 19-45 years), and there were 17 men and 16 women. The median Glasgow Coma Scale score at admission was 6.2 ± 0.7. Computed tomography (CT) included native CT, perfusion CT, and CT angiography.
  
  
  
  The mean CPPs before and after the CT scans were 95.9 ± 10.7 and 81.5 ± 12.5 mmHg respectively. The mean ICP before transport was 19.98 ± 5.3 mmHg (minimum 11.7; maximum 51.7). It was statistically significantly lower (p < 0.001) than during the transfer (26.1 ± 13.5 mmHg). During the period described all patients had increased ICP, especially during vertical movement in an elevator. During horizontal movement on the floor ICP remained higher (p < 0.05). The mean dynamic PRx before and after intrahospital transport was 0.23 ± 0.14 and 0.52 ± 0.04, respectively (p < 0.001). Average duration of the transfer and CT study was 15.3 ± 3.4 min.
  
  
  
  Intrahospital transport of patients with TBI may lead to a significant increase in ICP, dynamic PRx, and decreased CPP. The results suppose that the decision to perform brain CT in comatose patients with TBI should be carefully considered by clinicians.
authors.affiliation: Department of Polytrauma, Regional Hospital named after N.A. Semashko, 190, Rodionov str., Nizhny Novgorod, 603126, Russian Federation. xtro7@mail.ru.|Nizhniy Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation. xtro7@mail.ru.
authors.forename: Alex
authors.initials: A
authors.lastname: Trofimov
authors.affiliation: Department of Anaesthesiology, Regional Hospital named after N.A. Semashko, 190, Rodionov str., Nizhny Novgorod, Russian Federation.
authors.forename: George
authors.initials: G
authors.lastname: Kalentiev
authors.affiliation: Department of Anaesthesiology, Regional Hospital named after N.A. Semashko, 190, Rodionov str., Nizhny Novgorod, Russian Federation.
authors.forename: Michail
authors.initials: M
authors.lastname: Yuriev
authors.affiliation: Department of Neurosurgery, Centre Hospitalier Universitaire de Lyon, Lyon, France.
authors.forename: Vladislav
authors.initials: V
authors.lastname: Pavlov
authors.affiliation: Nizhniy Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation.
authors.forename: Vera
authors.initials: V
authors.lastname: Grigoryeva
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D000072226:Computed Tomography Angiography; D004607:Elevators and Escalators; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D055420:Perfusion Imaging; D014057:Tomography, X-Ray Computed; D014187:Transportation of Patients; D055815:Young Adult
keywords: Cerebral perfusion pressure; Head injury; Intracranial pressure; Intrahospital transport