Validation of a New Minimally Invasive Intracranial Pressure Monitoring Method by Direct Comparison with an Invasive Technique

Vilela, Gustavo Henrique Frigieri; Cabella, Brenno; Mascarenhas, S.; Czosnyka, Marek; Smielewski, Peter; Dias, Celeste; Cardim, Danilo; Mascarenhas, Yvonne Maria; Wang, Charles Chenwei; Andrade, Rodrigo; Lopes, Luiza Silva; Colli, Benedicto Oscar

doi:10.1007/978-3-319-22533-3_19

Cited by 29 publications

(28 citation statements)

References 6 publications

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“…Twelve (41%) patients had abnormal mCBFV; low mCBFV (< 40 cm/s) were observed in two patients, and elevated mCBFV (> 70 cm/s) were observed in ten patients. ; p = 0.58), eICP (13 [9][10][11][12][13][14][15][16][17][18][19][20][21] vs. 14 [10][11][12][13][14][15][16][17][18][19][20] mmHg; p = 0.96) and eCPP (68 [60-75] vs. 75 [60-85] mmHg; p = 0.09) were similar between the two assessments. Table 3 shows the concordance between abnormal values for the different parameters measured on rst assessment; most of patients abnormal eICP also had abnormal PI aor P2/P1 values.…”

Section: Discussionmentioning

confidence: 87%

Cerebral Hemodynamics and Intracranial Compliance Impairment In Critically Ill COVID-19 Patients: A Pilot Study

Brasil

Taccone

WAHYS

et al. 2020

Preprint

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Introduction: One of the possible mechanisms by which the new coronavirus (SARS-Cov2) could induce brain damage is the impairment of cerebrovascular hemodynamics (CVH) and intracranial compliance (ICC), due to the elevation of intracranial pressure (ICP). The main objective of this study was to assess the presence of CVH and ICC alterations in patients with COVID-19 and evaluate their association with short-term clinical outcome. Methods: 50 consecutive critically ill COVID-19 patients were studied with transcranial Doppler (TCD) and a non-invasive monitoring of ICC. Subjects were included on ICU admission; CVH was evaluated using mean flow velocities in the middle cerebral arteries (mCBFV), pulsatility index (PI) and estimated cerebral perfusion pressure (eCPP), while ICC using the P2/P1 ratio of estimated ICP curve (B4C device). The primary composite outcome was unsuccessful weaning from respiratory support or death at day 7.Results: On the first assessment (n= 50), only P2/P1 (1.20 [1.00-1.28] vs. 1.00 [0.88-1.16]; p=0.03) and eICP (14 [11-25] vs. 11 [7-15] mmHg; p=0.01) were significantly higher among patients with UO than others. Patients with UO had a significantly higher CVH/ICC score (9 [8-12] vs. 6 [5-7]; p<0.001) than those with favorable outcome; the area under the receiver operating curve (AUROC) for CVH/ICC score to predict UO was 0.86 (95% CIs 0.75-0.97); a score > 8.5 had 63 (46-77)% sensitivity and 87 (62-97)% specificity to predict UO. For those patients undergoing a second assessment (n=29) after a median of 11 (5-31) days, all measured variables were similar between the two time-points. No differences in the measured variables between ICU non-survivors (n=30) and survivors were observed.Conclusions: ICCI and CVH disturbances are often present in COVID-19 severe illness and could accurately predict early poor outcome.

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Section: Discussionmentioning

confidence: 87%

Cerebral Hemodynamics and Intracranial Compliance Impairment In Critically Ill COVID-19 Patients: A Pilot Study

Brasil

Taccone

WAHYS

et al. 2020

Preprint

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“…Yue et al[139] showed a positive correlation between increasing ICP and skull deformation. However, the concept of skull elasticity as a non-invasive modality of ICP monitoring is still in its infantile stages[139,140].…”

Section: Skull Elasticitymentioning

confidence: 99%

Intracranial pressure monitoring: Gold standard and recent innovations

Nag¹,

Sahu²,

Swain³

et al. 2019

WJCC

144

123

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Intracranial pressure monitoring (ICP) is based on the doctrine proposed by Monroe and Kellie centuries ago. With the advancement of technology and science, various invasive and non-invasive modalities of monitoring ICP continue to be developed. An ideal monitor to track ICP should be easy to use, accurate, reliable, reproducible, inexpensive and should not be associated with infection or haemorrhagic complications. Although the transducers connected to the extra ventricular drainage continue to be Gold Standard, its association with the likelihood of infection and haemorrhage have led to the search for alternate non-invasive methods of monitoring ICP. While Camino transducers, Strain gauge micro transducer based ICP monitoring devices and the Spiegelberg ICP monitor are the emerging technology in invasive ICP monitoring, optic nerve sheath diameter measurement, venous opthalmodynamometry, tympanic membrane displacement, tissue resonance analysis, tonometry, acoustoelasticity, distortion-product oto-acoustic emissions, trans cranial doppler, electro encephalogram, near infra-red spectroscopy, pupillometry, anterior fontanelle pressure monitoring, skull elasticity, jugular bulb monitoring, visual evoked response and radiological based assessment of ICP are the non-invasive methods which are assessed against the gold standard.

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“…The waves and pulses of intracranial pressure reach the skull causing expansions and retractions in its volume. The Braincare sensor is able to detect these changes and convert them into numerical values that are interpreted in real time and shown as graphs for the interpretation of health professionals ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis

Bollela

Frigieri

Vilar

et al. 2017

Braz J Med Biol Res

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Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema. Significant neurological decline can occur if elevated CSF pressures are inadequately managed. Various treatment strategies to address intracranial hypertension in this setting have been described, including: medical management, serial lumbar punctures, external lumbar and ventricular drain placement, and either ventricular or lumbar shunting. This study aims to evaluate the role of a non-invasive intracranial pressure (ICP-NI) monitoring in a critically ill HIV-CM patient.

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Validation of a New Minimally Invasive Intracranial Pressure Monitoring Method by Direct Comparison with an Invasive Technique

Cited by 29 publications

References 6 publications

Cerebral Hemodynamics and Intracranial Compliance Impairment In Critically Ill COVID-19 Patients: A Pilot Study

Cerebral Hemodynamics and Intracranial Compliance Impairment In Critically Ill COVID-19 Patients: A Pilot Study

Intracranial pressure monitoring: Gold standard and recent innovations

Noninvasive intracranial pressure monitoring for HIV-associated cryptococcal meningitis

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