Portable Magnetic Resonance Imaging for ICU Patients.

Autor:	Turpin J; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Unadkat P; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Thomas J; Division of Neurosurgery, Michigan State University College of Human Medicine, Ascension Providence Hospital, Southfield, MI., Kleiner N; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Khazanehdari S; Division of Neurocritical Care, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Wanchoo S; Division of Neurocritical Care, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Samuel K; Division of Neurocritical Care, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Moclair BO; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Black K; Division of Neuroradiology, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Dehdashti AR; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Narayan RK; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Temes R; Division of Neurocritical Care, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY., Schulder M; Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY.
Jazyk:	angličtina
Zdroj:	Critical care explorations [Crit Care Explor] 2020 Dec 21; Vol. 2 (12), pp. e0306. Date of Electronic Publication: 2020 Dec 21 (Print Publication: 2020).
DOI:	10.1097/CCE.0000000000000306
Abstrakt:	Objectives: Patients in ICUs often require neuroimaging to rule out a wide variety of intracranial problems. CT may be available in the ICU itself, but MRI has greater sensitivity for many conditions that affect the brain. However, transporting patients who are on ventilators and other life-sustaining devices is a labor-intensive process and involves placing the patient at risk for adverse events. This is a report of portable MRI in a clinical setting. Design: This is a prospective, nonrandomized, observational study at one institution, utilizing a 0.064-T, self-shielding, portable MRI in ventilated patients in an ICU setting. Setting: Academic medical center. Patients: Nineteen patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients selected for imaging had any of the following: 1) unexplained encephalopathy or coma, 2) seizures, 3) focal neurologic deficit, or 4) abnormal head CT. Imaging was performed in each patient's ICU room with a portable, self-shielding, 0.064-T MRI. Interventions: None. Measurements and Main Results: Among 19 patients, 20 MRI scans in seven ICUs were acquired between April 13, 2020, and April 23, 2020. No adverse events to patients or staff from MRI acquisition were reported. In 12 patients, abnormal findings were seen, which included increased fluid attenuated inversion recovery signal ( n = 12), hemorrhage ( n = 3), and diffusion-weighted imaging positivity ( n =3). Imaging led to changes in clinical management in five patients. Conclusions: In this case series of patients, use of portable MRI has been found to be safe, feasible, and led to changes in clinical management based on imaging results. However, future studies comparing results with other imaging modalities are required to understand fully the extent of its clinical utility. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
Databáze:	MEDLINE
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