CT-Guided Placement of a Neuromonitoring Suite in Swine for Trauma and Resuscitation Research

Authors

  • Janet Elise Bonin, BS University of Maryland School of Medicine
  • Hossam Abdou, MD R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Joseph Edwards, MD R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Neerav Patel, MD R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Michael Richmond, BS R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Noha Elansary, BS R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Kelly Poe, BS University of Maryland School of Medicine
  • Jonathan J Morrison, PhD FRCS R Adams Cowley Shock Trauma Center, University of Maryland Medical System

Keywords:

Neuromonitoring, Computed tomography, Swine research, Resuscitation research

Abstract

Background: This manuscript aims to describe a standardized method for placement of a neuromonitoring suite into the brain of a porcine model using CT guidance for use in trauma and resuscitation research.

Methods: A baseline CT allowed for precise planning of the placement of the neuromonitoring suite including measurement of skull thickness at the location of the intended burr hole. After the burr hole was drilled, three neuromonitoring probes (pressure catheter, temperature probe, and laser doppler flow probe) were advanced into the brain parenchyma of the swine. A subsequent CT confirmed appropriate placement of the neuromonitoring suite.

Results: Effective placement of the neuromonitoring suite was accomplished successfully and without complication in 6 Yorkshire swine. Mean duration of the procedure was 49.6 minutes ± 6.3. Representative data from one animal includes the following presented as mean ± standard deviation: intracranial pressure of 10 ± 0 mmHg, cerebral perfusion pressure of 61 ± 1 mmHg, intracranial temperature of 34.8 ± 0 °C, and brain perfusion of 704 ± 13 relative perfusion units.

Conclusions: This CT-guided method facilitates placement of a neuromonitoring suite in a safe and reliable manner. The use of a neuromonitoring suite using CT may offer valuable insight into cerebral perfusion in the context of endovascular resuscitation.

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Published

2021-05-01

Issue

Section

Tips and Techniques