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Telemetric ICP monitoring in children: a national questionnaire-based study
Sarah Hornshøj Pedersen1, Kasper Amund Henriksen2, Sara Duus Gustafsen2
1Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 8, 2100, Copenhagen, Denmark. sarah.skovlunde.hornshoej.pedersen.01@regionh.dk.
Insights
Telemetric intracranial pressure (ICP) monitoring in children improved parental security but did not reduce hospital visits. This technology offers a sense of safety and aids treatment guidance, despite not showing quantitative cost-benefits.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Biomedical Engineering
Background:
- Telemetric monitoring of intracranial pressure (ICP) offers long-term home monitoring, potentially reducing hospital admissions and diagnostic imaging.
- Paediatric ICP monitoring requires significant patient and parental collaboration and compliance.
Purpose of the Study:
- To investigate paediatric patient and parent perceptions of telemetric ICP system utility.
- To assess the impact of telemetric ICP monitoring on hospital contact history and potential cost-benefit in paediatric patients with cerebrospinal fluid disorders.
Main Methods:
- A nationwide questionnaire study was conducted with paediatric patients and their parents who had or have a telemetric ICP sensor.
- A retrospective review of electronic health records was performed for all participating children.
Main Results:
- Sixteen children (age 3-16) with 41 telemetric ICP sensors were included.
- Telephone contacts and outpatient visits increased post-implantation; no decrease in hospital admissions or length of stay was observed.
- Parents reported increased security and perceived the sensor as valuable for treatment guidance, though sensor size and external equipment bulk were noted drawbacks.
Conclusions:
- Telemetric ICP monitoring did not demonstrate a quantitative cost-benefit in this paediatric cohort.
- The system enhanced parental involvement and provided a greater sense of security.
- Despite limitations in cost-effectiveness, the technology serves as a valuable tool for managing paediatric cerebrospinal fluid disorders.
Purpose:
Telemetric monitoring of intracranial pressure (ICP) facilitates long-term measurements and home monitoring, thus potentially reducing diagnostic imaging and acute hospital admissions in favour of outpatient appointments. Especially in paediatric patients, telemetric ICP monitoring requires a high level of collaboration and compliance from patients and parents. In this study, we aim to systematically investigate (1) patient and parent perception of telemetric ICP system utility and (2) hospital contact history and thus the potential cost-benefit of telemetric ICP monitoring in paediatric patients with a cerebrospinal fluid disorder.
Methods:
We conducted a nationwide questionnaire study, including paediatric patients with either a current or previous telemetric ICP sensor and their parents. Additionally, a retrospective review of electronic health records for all included children was performed.
Results:
We included 16 children (age range 3-16 years), with a total of 41 telemetric ICP sensors implanted. Following sensor implantation, the frequency of telephone contacts and outpatient visits increased. No corresponding decrease in hospital admissions or total length of stay was found. The telemetric ICP sensor provided most parents with an improved sense of security and was seen as a necessary and valuable tool in treatment guidance. The size and shape of the sensor itself were reported as disadvantages, while the external monitoring equipment was reported as easy to use but too large and heavy for a child to carry.
Conclusion:
Though, in quantitative terms, there was no cost-benefit of the telemetric ICP sensor, it contributed to extended parental involvement and a sense of improved safety.
