Wertigkeit der thorakalen und abdominellen Computertomographie bei Intensivpatienten

Abstract

We evaluated in a retrospective study the therapeutic relevance of thoracic and abdominal CT examinations on 157 intensive-care patients with previously inconclusive radiological examinations. Indications for CT were sepsis (n = 105), rarely a decrease in haematocrit (n = 30), multiorgan failure (n = 16) or suspected aortic aneurysm (n = 6). In 83.4% of examinations CT detected clinically relevant features, in 44.3% positive CT studies resulted in invasive therapy within 72 hours and therefore changed patient management decisively. Our results justify the use of CT, enabling if necessary an on-target intervention, the advantages outweighing the inherent risks if the patient is exposed to the relatively small risk of being temporarily removed from the intensive-care unit for immediate invasive treatment.

CT-Guided Percutaneous Drainage and Fluid Aspiration in Intensive Care Patients

“…A different study reports dramatic changes in ICU patients' management (e.g. percutaneous drainage or surgery) in 44.3% following abdominal or thoracic CT (20). No transport-related problems occurred in our study.…”

“…No transport-related problems occurred in our study. We also believe that it is worthwile bringing ICU patients to CT in the case of sepsis and inconclusive US examinations (4, 8,20).…”

“…Diagnostic needle aspiration should therefore be performed to establish a precise diagnosis in all cases where pathologic fluid collections are demonstrated (7,8,12,20,21,24,25). We were able to rule out abdominal abscess or infected pancreatic necrosis in 17 patients where gram-stain and culture revealed no pyogenic organisms within the aspirated fluid.…”

CT-Guided Percutaneous Drainage and Fluid Aspiration in Intensive Care Patients

“…A different study reports dramatic changes in ICU patients' management (e.g. percutaneous drainage or surgery) in 44.3% following abdominal or tho racic CT (20). No transport-related problems occurred in our study.…”

“…No transport-related problems occurred in our study. We also believe that it is worthwile bringing ICU patients to CT in the case of sepsis and inconclusive US examinations (4,8,20).…”