An avoidable methodological failure in intracranial pressure monitoring using fiberoptic or solid state devices

Area of Science:

• Neurosurgery
• Biomedical Engineering
• Critical Care Medicine

Background:

• Intracranial pressure (ICP) monitoring is crucial for managing neurological conditions.
• Catheter blockage has been a limitation in traditional ICP measurement.
• Intraventricular microtransducers were developed to overcome these limitations.

Purpose of the Study:

• To evaluate the reliability of intraventricular microtransducers for intracranial pressure measurement.
• To identify potential methodological errors affecting device accuracy.
• To compare the performance of two types of intraventricular microtransducer devices.

Main Methods:

• 43 patients at risk for catheter occlusion received intraventricular microtransducers.
• Two device types were used: Type A (transducer inside catheter) and Type B (transducer on external catheter surface).
• Device performance was assessed during ventricular puncture, CSF drainage, and in cases of catheter blockage.

Main Results:

• Type A devices showed unreliable readings in 3/15 patients due to failed ventricular puncture.
• Erroneous pressure readings occurred in 4/12 patients with Type A devices, especially during CSF drainage.
• Type B devices demonstrated reliable pressure recordings without identified errors, regardless of CSF drainage.

Conclusions:

• Intraventricular microtransducers of Type A, requiring fluid coupling, are prone to failure.
• Type B intraventricular microtransducers offer a more reliable method for intracranial pressure monitoring.
• Methodological errors, particularly fluid coupling, can compromise the accuracy of certain ICP monitoring devices.