Neurocritical care and portable MR brain imaging.

Fixed conventional MRI systems can be inconvenient and inaccessible for providers and patients, especially when time is critical. Providers must weigh the benefits of the information that imaging will provide against the risks of transport-related adverse events resulting from, for example, delayed treatment and disruption of therapy.

One of the most challenging aspects of transporting a patient is coordinating a team to manage the patient as they move from the ICU to the imaging department. Such a team typically includes a respiratory therapist, a physician or resident, and an ICU nurse familiar with the patient. Further exacerbating the situation, if the department is already short-staffed, taking an ICU nurse away to assist in imaging a patient could put other patients at risk.

Intrahospital transport of patients is associated with numerous cardiovascular and respiratory risks that may limit timely and safe neuroimaging for critically ill patients¹. Unfortunately, even under the supervision of a well-trained transport team, adverse events may still occur in 20–70% of cases during transport to imaging². Martin et al. reported that ventilator asynchrony was the most frequent adverse event and put patients at a higher risk for pneumothorax, atelectasis, and ventilator-associated pneumonia³. Beckman et al. reported difficulties with hardware, challenges with lifts to move the patient, issues with infusion lines, and a lack of battery life for equipment needed to support the patient⁴.

By bringing diagnostic MR imaging to the point of care, a Swoop system may contribute to reducing the length of stay (and associated costs) in the ICU by enabling clinical care teams with the potential to optimize staffing, shorten the time to diagnosis, potentially prevent adverse events related to transport, and reduce patient care interruptions. In addition to the many benefits for patients and clinicians, the Swoop system is more cost-effective to own and maintain than conventional high-field MRI systems. And, unlike high-field MRI, which requires specialized infrastructure and radiologic technicians to operate, Swoop system operation, navigation, and safety training are simple, which allows for expanded user access.

For the patient, the Swoop system reduces potential adverse events associated with patient transport and brings neuroimaging to the bedside of critically ill patients who are too unstable for transport to radiology. Patients can remain connected to all intravenous lines and most ICU monitoring equipment as long as it remains outside the controlled access area of the Swoop system. The Swoop system complies with EMC emission standards for professional healthcare facilities and is not expected to affect most hospital equipment.

For the hospital, a Swoop system can help optimize staffing in the ICU by reducing the time required to coordinate clinical schedules and support staff for patient transport to radiology. This allows staff to remain where they’re needed most—in the ICU at the patient’s bedside or available to assist other patients. In addition to optimizing staff time, with a Swoop system in an ICU, results can be available three to seven hours earlier than those from conventional MRI⁵.

Additionally, a Swoop system enables clinicians to serially monitor a patient’s condition at the point of care, providing clinicians with real-time information to assist in critical care management decisions—without patient transport (and its associated risks) and without subjecting patients and staff to ionizing radiation from the portable CTs often used for serial follow-up scans.

The Swoop^_® system is indicated for use as a portable, ultra-low field magnetic resonance imaging device for producing images that display the internal structure of the head where full diagnostic examination is not clinically practical. When interpreted by a trained physician, these images provide information that can be useful in determining a diagnosis.

Studies show that the Swoop system can provide images at the point of care that clinicians have found useful for assessing:

• Change in patient symptoms with an unknown cause—looking for new bleeds, mass effect, extra-axial collection, etcetera^1,6,7,8
• Follow-up scans for clinically suspected or known strokes greater than 5mm²
• Change in ventricular size with or without intervention^6,9
• Change in an intraparenchymal hematoma²
• Change in extra-axial collection⁹
• Change in the imaging appearance of infarct⁷
• To follow or confirm stability¹⁰
• Mass effect and potential for midline shift¹¹
• Change post-thrombectomy¹²