Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review
Intracranial hypertension and adequacy of brain blood flow are primary concerns following traumatic brain injury. Intracranial pressure (ICP) monitoring is a critical diagnostic tool in neurocritical care. However, all ICP sensors, irrespective of design, are subject to systematic and random measure...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/23/7/3397 |
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| author | Adam I. Pelah Agnieszka Zakrzewska Leanne A. Calviello Teodoro Forcht Dagi Zofia Czosnyka Marek Czosnyka |
| author_facet | Adam I. Pelah Agnieszka Zakrzewska Leanne A. Calviello Teodoro Forcht Dagi Zofia Czosnyka Marek Czosnyka |
| author_sort | Adam I. Pelah |
| collection | DOAJ |
| description | Intracranial hypertension and adequacy of brain blood flow are primary concerns following traumatic brain injury. Intracranial pressure (ICP) monitoring is a critical diagnostic tool in neurocritical care. However, all ICP sensors, irrespective of design, are subject to systematic and random measurement inaccuracies that can affect patient care if overlooked or disregarded. The wide choice of sensors available to surgeons raises questions about performance and suitability for treatment. This observational study offers a critical review of the clinical and experimental assessment of ICP sensor accuracy and comments on the relationship between actual clinical performance, bench testing, and manufacturer specifications. Critically, on this basis, the study offers guidelines for the selection of ICP monitoring technologies, an important clinical decision. To complement this, a literature review on important ICP monitoring considerations was included. This study utilises illustrative clinical and laboratory material from 1200 TBI patients (collected from 1992 to 2019) to present several important points regarding the accuracy of in vivo implementation of contemporary ICP transducers. In addition, a thorough literature search was performed, with sources dating from 1960 to 2021. Sources considered to be relevant matched the keywords: “intraparenchymal ICP sensors”, “fiberoptic ICP sensors”, “piezoelectric strain gauge sensors”, “external ventricular drains”, “CSF reference pressure”, “ICP zero drift”, and “ICP measurement accuracy”. Based on single centre observations and the 76 sources reviewed in this paper, this material reports an overall anticipated measurement accuracy for intraparenchymal transducers of around ± 6.0 mm Hg with an average zero drift of <2.0 mm Hg. Precise ICP monitoring is a key tenet of neurocritical care, and accounting for zero drift is vital. Intraparenchymal piezoelectric strain gauge sensors are commonly implanted to monitor ICP. Laboratory bench testing results can differ from in vivo observations, revealing the shortcomings of current ICP sensors. |
| first_indexed | 2024-03-11T05:25:38Z |
| format | Article |
| id | doaj.art-3cdfede0092941a682b89af0a431faee |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-11T05:25:38Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-3cdfede0092941a682b89af0a431faee2023-11-17T17:31:56ZengMDPI AGSensors1424-82202023-03-01237339710.3390/s23073397Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature ReviewAdam I. Pelah0Agnieszka Zakrzewska1Leanne A. Calviello2Teodoro Forcht Dagi3Zofia Czosnyka4Marek Czosnyka5Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UKDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UKDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UKNeurosurgery, Mayo School of Medicine and Science, Rochester, MN 55905, USADivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UKDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UKIntracranial hypertension and adequacy of brain blood flow are primary concerns following traumatic brain injury. Intracranial pressure (ICP) monitoring is a critical diagnostic tool in neurocritical care. However, all ICP sensors, irrespective of design, are subject to systematic and random measurement inaccuracies that can affect patient care if overlooked or disregarded. The wide choice of sensors available to surgeons raises questions about performance and suitability for treatment. This observational study offers a critical review of the clinical and experimental assessment of ICP sensor accuracy and comments on the relationship between actual clinical performance, bench testing, and manufacturer specifications. Critically, on this basis, the study offers guidelines for the selection of ICP monitoring technologies, an important clinical decision. To complement this, a literature review on important ICP monitoring considerations was included. This study utilises illustrative clinical and laboratory material from 1200 TBI patients (collected from 1992 to 2019) to present several important points regarding the accuracy of in vivo implementation of contemporary ICP transducers. In addition, a thorough literature search was performed, with sources dating from 1960 to 2021. Sources considered to be relevant matched the keywords: “intraparenchymal ICP sensors”, “fiberoptic ICP sensors”, “piezoelectric strain gauge sensors”, “external ventricular drains”, “CSF reference pressure”, “ICP zero drift”, and “ICP measurement accuracy”. Based on single centre observations and the 76 sources reviewed in this paper, this material reports an overall anticipated measurement accuracy for intraparenchymal transducers of around ± 6.0 mm Hg with an average zero drift of <2.0 mm Hg. Precise ICP monitoring is a key tenet of neurocritical care, and accounting for zero drift is vital. Intraparenchymal piezoelectric strain gauge sensors are commonly implanted to monitor ICP. Laboratory bench testing results can differ from in vivo observations, revealing the shortcomings of current ICP sensors.https://www.mdpi.com/1424-8220/23/7/3397intracranial pressureintraparenchymal sensorzero driftbrain injuryICP sensorhead trauma |
| spellingShingle | Adam I. Pelah Agnieszka Zakrzewska Leanne A. Calviello Teodoro Forcht Dagi Zofia Czosnyka Marek Czosnyka Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review Sensors intracranial pressure intraparenchymal sensor zero drift brain injury ICP sensor head trauma |
| title | Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review |
| title_full | Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review |
| title_fullStr | Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review |
| title_full_unstemmed | Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review |
| title_short | Accuracy of Intracranial Pressure Monitoring—Single Centre Observational Study and Literature Review |
| title_sort | accuracy of intracranial pressure monitoring single centre observational study and literature review |
| topic | intracranial pressure intraparenchymal sensor zero drift brain injury ICP sensor head trauma |
| url | https://www.mdpi.com/1424-8220/23/7/3397 |
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