Utilization of whole body computed tomography in polytrauma patients

Abstract

Objective:To determine the safety, feasibility, and utility of whole body computed tomography (WBCT) in polytrauma patients. A second objective was to describe the utilization of the Vet-Mouse Trap for sedated WBCT in polytrauma patients. Methods:A prospective, observational study in a high-volume private practice. Any cat or dog weighing <20 kg that presented to the emergency department following a polytrauma was eligible. Patients were given analgesia and sedation prior to placement in the VetMouse Trap. A WBCT was then performed. Results: A total of 16 patients (8 dogs and 8 cats) met inclusion criteria. All patients presented with blunt trauma; 3 also had evidence of penetrating wounds. Five (31.25%) patients met inclusion criteria for WBCT based on their neurological evaluation. Five (31.5%) were non-ambulatory with suspicion of orthopedic injury, and 37.5% met additional criteria for WBCT. The most common areas of injury were head (43.7%), lungs (25%), and pelvis (25%). Four patients (25%) had evidence of cavitary effusion that was not seen on focused assessment using sonography for trauma (FAST) scan. No patient had any adverse events during the CT. Conclusion: This study demonstrated successful WBCT imaging of the sedated small animal polytrauma patient with the VetMouse Trap. K E Y W O R D S small animal, polytrauma, computed tomography 1 28wileyonlinelibrary.com/journal/vec J Vet Emerg Crit Care. 2020;30:28-33.

Comparing diagnostic findings and cost of whole body computed tomography to traditional diagnostic imaging in polytrauma patients

“…In veterinary patients, limitations of WBCT in comparison to traditional diagnostic tests are comparative cost, feasibility due to equipment and staffing, and concerns for placing a hemodynamically unstable patient under anesthesia. A recent study found that the utilization of a transparent cylindrical restraint device c to perform sedated WBCT in polytrauma patients was a feasible modality for successful identification of injuries in sedated veterinary patients 32 . The aforementioned study demonstrated that good quality images were able to be obtained with the majority of patients being sedated.…”

“…WBCT utilization in trauma patients has not been extensively studied in veterinary medicine due to concerns regarding cost, accessibility, and patient stability with regard to general anesthesia 32 . However, a recent study demonstrated successful use of WBCT in evaluation of small animal polytrauma patients with minimal sedation 32 .…”

CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury

“…In recent years, CT has become increasingly used as a diagnostic tool for assessing traumatic injuries in veterinary medicine. [17][18][19] While CT scans require sedation in most patients, the use of head and whole body CT scanning following traumatic injuries provides detailed anatomical information at high resolution in a relatively short time. This wealth of cross-sectional data allows for accurate diagnosis and assists in treatment planning, including surgery.…”

Deer Rescue in Tuscany: Retrospective Analysis and Assessment of Radiography Diagnoses

“…Thoracic and abdominal ultrasound (US), and computed tomography (CT) are also useful diagnostic imaging techniques for traumatized animals [ 42 , 43 , 44 , 45 ]. The US assessment of the thorax and abdomen is reported to be a rapid and accurate method to detect traumas in dogs [ 42 ].…”

“…CT is considered the gold standard for the evaluation of acute canine spinal trauma [ 44 ]. It also appears to be more sensitive than ultrasound and radiography in the identification of thoracic pathologies in traumatized patients (i.e., pleural fluid, pulmonary contusion), but further studies are needed [ 45 ]. Thoracic or abdomen US or CT were not performed in the ungulates enrolled in this study; thus, a comparison between different diagnostic imaging procedures for the diagnosis of traumas was not possible.…”