Camino(R) intracranial pressure monitor: prospective study of accuracy and complications

Abstract

Objectives-The fibreoptic device is a type of intracranial pressure monitor which seems to oVer certain advantages over conventional monitoring systems. This study was undertaken to analyse the accuracy, drift characteristics, and complications of the Camino® fibreoptic device. Methods-One hundred and eight Camino® intracranial pressure (ICP) devices, in their three modalities, were implanted during 1997. The most frequent indication for monitoring was severe head injury due to road traYc accidents. Results-Sixty eight probe tips were cultured; 13.2% of the cases had a positive culture without clinical signs of infection, and 2.9% had a positive culture with clinical signs of ventriculitis. The most common isolated pathogen was Staphylococcus epidermidis. All patients were under cephalosporin prophylaxis during monitoring. Haemorrhage rate in patients without coagulation disorders was 2.1% and 15.3% in patients with coagulation abnormalities. Drift characteristics were studied in 56 cases; there was no drifting from the values expected according to the manufacturer's specifications in 34 probes. There was no relation between direction of the drift and duration of placement, nor between drift and time. Conclusions-Although the complication and drift rates were similar to those reported elsewhere, there was no correlation between the direction of the drift and long term monitoring despite the fact that some published papers refer to overestimation of values with time with this type of device. (J Neurol Neurosurg Psychiatry 2000;69:82-86)

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

“…In a 1997 series of 108 intraparenchymal devices, the rate of infection was 2.9% and the rate of intracranial hemorrhage was 2.1% (15.3% in patients with coagulopathies). 191 Two of 22 patients (9%) patients in the placebo arm of a trial of intraventricular thrombolysis developed ventriculitis, but these patients had multiple intrathecal injections, which could potentially increase the risk of infection. 184 Before insertion of a monitoring device, the patient's coagulation status should be evaluated.…”

Utilidad de la monitorización de la PIC en pacientes con sospecha de disfunción valvular

“…Constituye un método relativamente sencillo, seguro 14,16,17,21 y que aporta una valiosa información. En algunos trabajos, se utiliza el registro de PIC para evaluar fundamentalmente la presión media, sin atender excesivamente a la morfología del trazado 13 .…”

Intraparenchymal intracranial pressure monitoring in patients with acute liver failure

“…The hemorrhagic complication is observed in 2.8% of the cases, and the incidence of bacterial colonization has been brought down to 0-14% of the cases [5][6][7] . In a prospective study of intraparenchymal monitoring, haemorrhage was observed in 2.1% of patients without alteration of the coagulation, and in 15.3% of their counterparts with coagulopathy 8 . In another study, 118 patients with intracranial pathology but without coagulopathy were evaluated, and the incidence of observed complications was: infection (0.7%), intraparenchymal haematoma (5.1%) and complications related with technical aspects (23.5%) 9 .…”