Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement

Raabe, Andreas; Totzauer, Ralf; Meyer, Ole; Stöckel, R; Hohrein, D; Schöche, J

doi:10.1097/00006123-199808000-00073

Cited by 32 publications

(9 citation statements)

References 17 publications

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“…It is well known that ICP values obtained from the epidural compartment may be artifactually higher than those obtained in other craniospinal compartments (7,9,13,30,35,37). Nevertheless, in a stable patient, changes in ICP and qualitative information (graphic ICP recordings) are absolutely parallel and can be used interchangeably in some types of patients (13,30,35,37).…”

Section: Influence Of Epidural Monitoring On Icp Gradientsmentioning

confidence: 99%

Posture-induced Changes in Intracranial Pressure: A Comparative Study in Patients with and without a Cerebrospinal Fluid Block at the Craniovertebral Junction

et al. 2006

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Section: Influence Of Epidural Monitoring On Icp Gradientsmentioning

confidence: 99%

Posture-induced Changes in Intracranial Pressure: A Comparative Study in Patients with and without a Cerebrospinal Fluid Block at the Craniovertebral Junction

et al. 2006

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“…Raabe et al 20 also described this latency. The authors conclu ded that these drifting periods could be found during throu ghout the entire measurement.…”

mentioning

confidence: 82%

“…The authors conclu ded that these drifting periods could be found during throu ghout the entire measurement. The biomechanical conditions in the epidural space can influence pressure distribution to the sensor and interfere with epidural pressure system measurements 16,20 . The model described here seems useful for understan ding some important pathophysiological characteristics of acute IH.…”

mentioning

confidence: 99%

Experimental model of intracranial hypertension with continuous multiparametric monitoring in swine

Andrade

Soares

Patriota

et al. 2013

Arq. Neuro-Psiquiatr.

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Intracranial hypertension (IH) develops in approximately 50% of all patients with severe traumatic brain injury (TBI) and is more common in patients with intracranial hematoma (ICH) 1,2 . Therefore, it is very important to identify a suitable animal model to study and understand the pathophysiology of refractory IH to develop effective treatments.Many models of neurosurgical experiments in small animals, such as rats and cats, have been developed; however, compared to humans, they have smaller brain volumes and more distinct behaviors 3,4 . While there are existing porcine models, they simulate ICH by infusing autologous blood into the brain tissue and do not replicate intracranial lesions [3][4][5][6] . ABSTRACTObjective: Intracranial hypertension (IH) develops in approximately 50% of all patients with severe traumatic brain injury (TBI). Therefore, it is very important to identify a suitable animal model to study and understand the pathophysiology of refractory IH to develop effective treatments. Methods: We describe a new experimental porcine model designed to simulate expansive brain hematoma causing IH. Under anesthesia, IH was simulated with a balloon insufflation. The IH variables were measured with intracranial pressure (ICP) parenchymal monitoring, epidural, cerebral oximetry, and transcranial Doppler (TCD). Results: None of the animals died during the experiment. The ICP epidural showed a slower rise compared with parenchymal ICP. We found a correlation between ICP and cerebral oximetry. Conclusion: The model described here seems useful to understand some of the pathophysiological characteristics of acute IH. Keywords: experimental model, intracranial hypertension, transcranial doppler sonography. RESUMOObjetivo: A hipertensão intracraniana (HIC) ocorre em até 50% de todos os pacientes com traumatismo cranioencefálico (TCE). Por isso, é importante estabelecer um modelo animal adequado para estudar a fisiopatologia da HIC refratária, com a perspectiva de desenvolver tratamentos eficazes. Métodos: Os animais foram submetidos a um protocolo padrão de anestesia. A hipertensão intracraniana foi estabelecida através de insuflação de um balão. As variáveis HIC foram medidas com a pressão intracraniana (PIC) do parênquima, oximetria, epidural e doppler transcraniano. Resultados: A PIC epidural apresentou elevação mais lenta, comparada com a PIC parenquimal. Houve correlação entre a PIC e a oximetria cerebral. O registro da PIC, oximetria e índice de pulsatilidade foi realizado em todos os animais sem dificuldade. Conclusão: O modelo descrito parece ser útil para a compreensão de algumas características fisiopatológicas na HIC aguda.Palavras-chave: pressão intracraniana, ultrassonografia, doppler transcraniana, modelos experimentais.

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“…In den letzten Jahren haben sich insbesondere die Methoden der intraparenchymalen und intraventrikulären ICP-Messung gegenüber der epiduralen und subduralen/subarachnoidalen Messung durchgesetzt. Zwar ist die epidurale ICP-Messung als ¹weniger invasivª anzusehen, da die Dura mater unverletzt bleibt, jedoch ist sie im Hinblick auf die Qualität der Messung der intraparenchymalen und intraventrikulären Messung deutlich unterlegen [6,7]. Tab.…”

Section: Monitoring Des Intrakraniellen Drucksunclassified

Neuromonitoring bei erhöhtem intrakraniellen Druck

Meixensberger¹,

Jaeger²

2002

Akt Neurol

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EinleitungErhöhter intrakranieller Druck (ICP, Intra Cranial Pressure) und das damit verbundene Risiko einer erniedrigten zerebralen Perfusion (CPP, Cerebral Perfusion Pressure), sind wesentliche Faktoren der Sekundärschädigung des Gehirns nach Vorliegen eines zerebralen Primärschadens, der bis heute als nicht therapierbar angesehen wird [1 ± 3]. Hieraus ergibt sich in der Neurointensivmedizin konsequenterweise die Forderung nach einer kontinuierlichen Überwachung des intrakraniellen Druckes und des zerebralen Perfusionsdruckes, der die eigentliche therapeutische Zielgröûe darstellt [4].Neben den klinisch bereits seit Jahrzehnten etablierten Verfahren der kontinuierlichen Messung des ICP [5], sind in den letzten Jahren weitere Monitoringmethoden, insbesondere zur Überwa-chung der zerebralen Oxygenation und des Metabolismus, zum Einsatz gekommen, die durch Erkennen zerebraler Hypoxien die Möglichkeit eröffnen, das Ausmaû der ischämischen Sekundär-schädigung zu erkennen und gezielt zu behandeln.Der Einsatz einer Überwachungstechnologie muss dabei unter zwei grundsätzlichen Aspekten diskutiert werden: Zum einen ist eine zuverlässige, artefaktfreie, sensitive, praktikable und patientensichere Erfassung des Messparameters zu gewährleisten; zum anderen ist die Wertigkeit des Einsatzes einer Überwa-chungstechnologie im Hinblick auf den erfassten Parameter für eine Erkrankung zu definieren und die Beeinflussung gezielter therapeutischer Maûnahmen zu evaluieren. Letztendlich muss, um der Forderung nach evidenzbasierter Medizin gerecht zu werden, geklärt werden, ob die Erfassung und Therapie des Messparameters die Prognose der Erkrankung verbessern. ZusammenfassungDas Ausmaû des sekundären Hirnschadens, der nach einer akuten Erkrankung des Gehirns auftritt, ist wesentlich für das klinische Ergebnis verantwortlich. Die Methoden des erweiterten Neuromonitorings bieten die Möglichkeit der frühzeitigen Erkennung von derartigen sekundären hypoxischen und ischämi-schen Ereignissen. Ergänzend zur kontinuierlichen Erfassung des intrakraniellen Drucks bieten die Bulbus-jugularis-Oxymetrie, die Messung des Sauerstoffpartialdrucks im Hirngewebe und die Nah-Infrarot-Spektroskopie Informationen über die zerebrale Oxygenation. Die zerebrale Mikrodialyse erlaubt Einblicke in den Hirnstoffwechsel. Wir möchten einen Überblick über die gängigen Techniken des erweiterten Neuromonitorings geben und deren diagnostischen und therapeutischen Nutzen besprechen. AbstractSecondary neuronal damage caused by cerebral hypoxia and ischemia following acute brain disease is a major determinant of patient outcome. Advanced neuromonitoring allows early detection of such insults. In addition to continuous intracranial pressure monitoring, methdods such as jugular bulb oximetry, partial brain tissue oxygen pressure, and near-infrared spectroscopy provide information regarding cerebral oxygenation. Cerebral microdialysis gives insight into brain metabolism. Here, we summarise the currently available techniques in advanced neuromonitoring and discuss their dia...

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Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement

Cited by 32 publications

References 17 publications

Posture-induced Changes in Intracranial Pressure: A Comparative Study in Patients with and without a Cerebrospinal Fluid Block at the Craniovertebral Junction

Posture-induced Changes in Intracranial Pressure: A Comparative Study in Patients with and without a Cerebrospinal Fluid Block at the Craniovertebral Junction

Experimental model of intracranial hypertension with continuous multiparametric monitoring in swine

Neuromonitoring bei erhöhtem intrakraniellen Druck

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