Close-to-Bedside Magnetic Resonance Imaging in the Neurocritical Care Unit: Descriptive Observational Study Exploring Patient Safety of a Novel Patient Transportation Method.

Abstract

Unstable patients in the neurocritical care unit (NCCU) need repeated diagnostic imaging. Intrahospital transports of such patients is hazardous where even small changes in physiology may lead to secondary brain injury. In this study we describe the workflow, safety aspects and reflect on our initial experience of close-to-bedside magnetic resonance (MR) imaging in the NCCU. A descriptive observational study was conducted to assess the safety of the transportation method and potential physiological changes associated with it. Eligible patients referred for MR imaging while in critical care at the NCCU between December 2021 and April 2022 were included. Physiological variables, including mean arterial pressure, heart rate, oxygen saturation, and fraction of inspired oxygen, were documented by critical care nurses before patient transfer, midway through MR scanning, and upon return to the NCCU bed. The suite's setup, including equipment and staffing, is detailed. Patient preparation and transportation procedures are described, emphasizing safety protocols. No main detrimental physiological changes occurred in patients undergoing close-to-bedside MR scanning included in our study (n = 45). No hazardous safety incidents occurred during the conduction of this study using this transportation approach. The concept of close-to-bedside MR imaging in the NCCU appears safe and minimizes numerous risks associated with intrahospital transports of unstable patients in neurocritical care. Safe access to repeated MR scanning of NCCU patients enables us to further advance the field of neurocritical care.