Intracranial pressure monitoring in children: comparison of external ventricular device with the fiberoptic system

Abstract

Several intracranial pressure monitoring devices have been developed in the past several years. We have recently adopted the Camino fiberoptic device that permits subdural, intraparenchymal, and intraventricular monitoring. In this report we compare experiences in monitoring a group of pediatric patients with severe craniocerebral trauma and coma, grouped according to severity of Glasgow Coma Scale score. Patient age ranged from 2 to 16 years. Twelve patients were monitored by a ventricular catheter and 37, treated more recently, by a Camino fiberoptic device. The study demonstrated that the fiberoptic device and the ventricular catheter have the same accuracy and reliability. The fiberoptic method correlates very closely with the ventriculostomy method, but the pressure values are always 3 +/- 2 mmHg lower than those obtained with the conventional pressure transducer system, especially in more critically ill patients. This new technique is also easier to implant, safer to use, has minimal drift, and is minimally invasive, which particularly speaks for its use in pediatric patients.

Advances in Intracranial Pressure Monitoring and Its Significance in Managing Traumatic Brain Injury

“…The optimal positioning of the transducer is determined by factors including the desired accuracy, duration of monitoring, acceptable drift and complications, therapeutic benefits, etc . The gold standard for transducer placement is the intraventricular site [ 46 , 47 , 48 , 49 , 50 , 51 ], which can also be therapeutically beneficial if a CSF drainage mechanism is included in the system. Intraparenchymal and sub-dural systems are comparable to intraventricular methods [ 51 , 52 , 53 ]; however, some studies have reported that these methods do not always correlate well with the gold standard [ 47 , 54 , 55 , 56 ].…”

“…The gold standard for transducer placement is the intraventricular site [ 46 , 47 , 48 , 49 , 50 , 51 ], which can also be therapeutically beneficial if a CSF drainage mechanism is included in the system. Intraparenchymal and sub-dural systems are comparable to intraventricular methods [ 51 , 52 , 53 ]; however, some studies have reported that these methods do not always correlate well with the gold standard [ 47 , 54 , 55 , 56 ]. Fluid filled epidural or sub-arachnoid [ 48 , 49 , 50 , 57 , 58 , 59 ] and pneumatic epidural methods [ 60 , 61 , 62 ] are not preferred techniques as they are less accurate in reference to the intraventricular methods.…”

Endotracheal suctioning in children with severe traumatic brain injury: a literature review

“…A further problem that affects most of the studies is the use of multiple ICP monitoring devices and sites, for the primary outcome measure, ICP. There is a well‐documented variability between these sites and between different devices (Gambardella et al ., 1993; Signorini et al , 1998).…”

Multimodality Neuromonitoring in Pediatric Neurocritical Care: Review of the Current Resources

“…In the 1960’s, Lundberg initiated the advent of intraventricular pressure monitoring [ 11 ], and the cannulation of the ventricle became the gold standard for measuring ICP. However, ventriculostomy has the risks of malposition, hemorrhage, and infection as potentially associated adverse events [ 12 - 13 ]. As a result of this, alternative ICP monitoring modalities have developed over the last few decades [ 14 - 15 ].…”