Abstract
OBJECTIVES—The fibreoptic device is a type of intracranial pressure monitor which seems to offer 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 traffic 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.
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- Aucoin P. J., Kotilainen H. R., Gantz N. M., Davidson R., Kellogg P., Stone B. Intracranial pressure monitors. Epidemiologic study of risk factors and infections. Am J Med. 1986 Mar;80(3):369–376. doi: 10.1016/0002-9343(86)90708-4. [DOI] [PubMed] [Google Scholar]
- Bavetta S., Norris J. S., Wyatt M., Sutcliffe J. C., Hamlyn P. J. Prospective study of zero drift in fiberoptic pressure monitors used in clinical practice. J Neurosurg. 1997 Jun;86(6):927–930. doi: 10.3171/jns.1997.86.6.0927. [DOI] [PubMed] [Google Scholar]
- Blei A. T., Olafsson S., Webster S., Levy R. Complications of intracranial pressure monitoring in fulminant hepatic failure. Lancet. 1993 Jan 16;341(8838):157–158. doi: 10.1016/0140-6736(93)90016-a. [DOI] [PubMed] [Google Scholar]
- Clark W. C., Muhlbauer M. S., Lowrey R., Hartman M., Ray M. W., Watridge C. B. Complications of intracranial pressure monitoring in trauma patients. Neurosurgery. 1989 Jul;25(1):20–24. doi: 10.1097/00006123-198907000-00004. [DOI] [PubMed] [Google Scholar]
- Crutchfield J. S., Narayan R. K., Robertson C. S., Michael L. H. Evaluation of a fiberoptic intracranial pressure monitor. J Neurosurg. 1990 Mar;72(3):482–487. doi: 10.3171/jns.1990.72.3.0482. [DOI] [PubMed] [Google Scholar]
- Czosnyka M., Czosnyka Z., Pickard J. D. Laboratory testing of three intracranial pressure microtransducers: technical report. Neurosurgery. 1996 Jan;38(1):219–224. doi: 10.1097/00006123-199601000-00053. [DOI] [PubMed] [Google Scholar]
- Czosnyka M., Harland S., Piechnik S., Kirkpatrick P., Czosnyka Z., Menon D. Systematic overestimation of intracranial pressure measured using a Camino pressure monitor. J Neurol Neurosurg Psychiatry. 1996 Oct;61(4):427–428. doi: 10.1136/jnnp.61.4.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eddy V. A., Vitsky J. L., Rutherford E. J., Morris J. A., Jr Aggressive use of ICP monitoring is safe and alters patient care. Am Surg. 1995 Jan;61(1):24–29. [PubMed] [Google Scholar]
- Hollingsworth-Fridlund P., Vos H., Daily E. K. Use of fiber-optic pressure transducer for intracranial pressure measurements: a preliminary report. Heart Lung. 1988 Mar;17(2):111–120. [PubMed] [Google Scholar]
- Jarvis C. W., Saxena K. M. Does prior antibiotic treatment hamper the diagnosis of acute bacterial meningitis? An analysis of a series of 135 childhood cases. Clin Pediatr (Phila) 1972 Apr;11(4):201–204. doi: 10.1177/000992287201100406. [DOI] [PubMed] [Google Scholar]
- Keays R. T., Alexander G. J., Williams R. The safety and value of extradural intracranial pressure monitors in fulminant hepatic failure. J Hepatol. 1993 Jun;18(2):205–209. doi: 10.1016/s0168-8278(05)80247-8. [DOI] [PubMed] [Google Scholar]
- Lidofsky S. D., Bass N. M., Prager M. C., Washington D. E., Read A. E., Wright T. L., Ascher N. L., Roberts J. P., Scharschmidt B. F., Lake J. R. Intracranial pressure monitoring and liver transplantation for fulminant hepatic failure. Hepatology. 1992 Jul;16(1):1–7. doi: 10.1002/hep.1840160102. [DOI] [PubMed] [Google Scholar]
- Mayhall C. G., Archer N. H., Lamb V. A., Spadora A. C., Baggett J. W., Ward J. D., Narayan R. K. Ventriculostomy-related infections. A prospective epidemiologic study. N Engl J Med. 1984 Mar 1;310(9):553–559. doi: 10.1056/NEJM198403013100903. [DOI] [PubMed] [Google Scholar]
- North B., Reilly P. Comparison among three methods of intracranial pressure recording. Neurosurgery. 1986 Jun;18(6):730–732. doi: 10.1227/00006123-198606000-00009. [DOI] [PubMed] [Google Scholar]
- Ohrström J. K., Skou J. K., Ejlertsen T., Kosteljanetz M. Infected ventriculostomy: bacteriology and treatment. Acta Neurochir (Wien) 1989;100(1-2):67–69. doi: 10.1007/BF01405277. [DOI] [PubMed] [Google Scholar]
- Ostrup R. C., Luerssen T. G., Marshall L. F., Zornow M. H. Continuous monitoring of intracranial pressure with a miniaturized fiberoptic device. J Neurosurg. 1987 Aug;67(2):206–209. doi: 10.3171/jns.1987.67.2.0206. [DOI] [PubMed] [Google Scholar]
- Pearce J. M. Johann Jakob Wepfer (1620-95) and cerebral haemorrhage. J Neurol Neurosurg Psychiatry. 1997 Apr;62(4):387–387. doi: 10.1136/jnnp.62.4.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Romer F. K. Difficulties in the diagnosis of bacterial meningitis. Evaluation of antibiotic pretreatment and causes of admission to hospital. Lancet. 1977 Aug 13;2(8033):345–347. doi: 10.1016/s0140-6736(77)91498-2. [DOI] [PubMed] [Google Scholar]
- Rosner M. J., Becker D. P. ICP monitoring: complications and associated factors. Clin Neurosurg. 1976;23:494–519. doi: 10.1093/neurosurgery/23.cn_suppl_1.494. [DOI] [PubMed] [Google Scholar]
- Shapiro S., Bowman R., Callahan J., Wolfla C. The fiberoptic intraparenchymal cerebral pressure monitor in 244 patients. Surg Neurol. 1996 Mar;45(3):278–282. doi: 10.1016/0090-3019(95)00359-2. [DOI] [PubMed] [Google Scholar]
- Smith R. W., Alksne J. F. Infections complicating the use of external ventriculostomy. J Neurosurg. 1976 May;44(5):567–570. doi: 10.3171/jns.1976.44.5.0567. [DOI] [PubMed] [Google Scholar]
- Stenager E., Gerner-Smidt P., Kock-Jensen C. Ventriculostomy-related infections--an epidemiological study. Acta Neurochir (Wien) 1986;83(1-2):20–23. doi: 10.1007/BF01420503. [DOI] [PubMed] [Google Scholar]
- Sundbärg G., Nordström C. H., Messeter K., Söderström S. A comparison of intraparenchymatous and intraventricular pressure recording in clinical practice. J Neurosurg. 1987 Dec;67(6):841–845. doi: 10.3171/jns.1987.67.6.0841. [DOI] [PubMed] [Google Scholar]
- Winfield J. A., Rosenthal P., Kanter R. K., Casella G. Duration of intracranial pressure monitoring does not predict daily risk of infectious complications. Neurosurgery. 1993 Sep;33(3):424–431. doi: 10.1227/00006123-199309000-00011. [DOI] [PubMed] [Google Scholar]
- Winn H. R., Dacey R. G., Jane J. A. Intracranial subarachnoid pressure recording: experience with 650 patients. Surg Neurol. 1977 Jul;8(1):41–47. [PubMed] [Google Scholar]