Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement

Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern... AbstractOBJECTIVEIn recent years, new devices for epidural pressure (EDP) measurement have been developed, with claims of improved accuracy. However, there have been no new data from simultaneous pressure measurements to reverse the skepticism regarding this technique.METHODSThe reliability of EDP recording was investigated in 26 patients with severe head injuries, during, simultaneous measurement of ipsilateral intraventricular pressure (IVP) or intraparenchymal pressure (IPP).RESULTSPeriods of simultaneous measurement ranged from 3.3 to 168 hours. Technical failure occurred in five cases. Clinically significant erroneous pressure values (defined as differences of >10 mm Hg between EDP and : IVP or IPP, lasting for >10 min) occurred in 7 of 21 measurements (33%). In three of these seven cases (43%) the difference between the EDP and the IVP or IPP remained nearly stable throughout the period of observation, whereas in four cases (57%) significant drifting over time was observed. Analysis of the transfer function calculated for the first to sixth harmonics between the EDP and the IVP or IPP showed no significant differences between the pulse pressure waveforms, even when significant drifting of more than 20 mm Hg occurred.CONCLUSIONThe reliability of EDP measurement has not improved, compared with 10 years ago. Using this technique, one must be aware of the possibility of overestimating intracranial pressure by more than 10 mm Hg and the possibility of significant drifting of EDP over time, which argues against the use of this method even tor trend analysis. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement

Reliability of Epidural Pressure Measurement in Clinical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement

IN S T R U M E N T A T IO N ASSESSM EN TS Reliability of Epidural Pressure Measurement in C lin ical Practice: Behavior of Three Modern Sensors during Simultaneous Ipsilateral Intraventricular or Intraparenchymal Pressure Measurement Andreas Raabe, M.D., Ralf Totzauer, S.A., Ole Meyer, S.A., Rolf Stockel, M.D., Ditmar Hohrein, M.D., Jochen Schoche, M.D. Department of Neurosurgery (AR), University of Leipzig, Leipzig, Germany; Section of System Theory (RT, OM), Technical University, Chemnitz, Germany; and Department of Neurosurgery (RS, D H , )S), Klinikum Chemnitz, Chemnitz, Germany O B JE C T IV E : In recent years, new devices for epidural pressure (EDP) measurement have been developed, with 1 claims of improved accuracy. However, there have been no new data from simultaneous pressure measurements to reverse the skepticism regarding this technique. M E T H O D S : The reliability of EDP recording was investigated in 26 patients with severe head injuries, during , simultaneous measurement of ipsilateral intraventricular pressure (IVP) or intraparenchymal pressure (IPP). RESULTS: Periods of simultaneous measurement ranged from 3.3 to 168 hours. Technical failure occurred in five j cases. C lin ically significant erroneous pressure values (defined as differences of > 1 0 mm H g between EDP and : IVP or IPP, lasting for > 1 0 min) occurred in 7 of 21 measurements ( 3 3 % ) . In three of these seven cases (43%) : the difference between the EDP and the IVP or IPP remained nearly stable throughout the period of observation, : whereas in four cases (5 7 % ) significant drifting over time was observed. Analysis of the transfer function calculated for the first to sixth harmonics between the EDP and the IVP or IPP showed no significant differences between the pulse pressure waveforms, even when significant drifting of more than 20 mm H g occurred. C O N C L U S IO N : The reliability of EDP measurement has not improved, compared with 10 years ago. Using this ....
Loading next page...
 
/lp/ou_press/reliability-of-epidural-pressure-measurement-in-clinical-practice-PSZE0kcTky
Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199808000-00073
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEIn recent years, new devices for epidural pressure (EDP) measurement have been developed, with claims of improved accuracy. However, there have been no new data from simultaneous pressure measurements to reverse the skepticism regarding this technique.METHODSThe reliability of EDP recording was investigated in 26 patients with severe head injuries, during, simultaneous measurement of ipsilateral intraventricular pressure (IVP) or intraparenchymal pressure (IPP).RESULTSPeriods of simultaneous measurement ranged from 3.3 to 168 hours. Technical failure occurred in five cases. Clinically significant erroneous pressure values (defined as differences of >10 mm Hg between EDP and : IVP or IPP, lasting for >10 min) occurred in 7 of 21 measurements (33%). In three of these seven cases (43%) the difference between the EDP and the IVP or IPP remained nearly stable throughout the period of observation, whereas in four cases (57%) significant drifting over time was observed. Analysis of the transfer function calculated for the first to sixth harmonics between the EDP and the IVP or IPP showed no significant differences between the pulse pressure waveforms, even when significant drifting of more than 20 mm Hg occurred.CONCLUSIONThe reliability of EDP measurement has not improved, compared with 10 years ago. Using this technique, one must be aware of the possibility of overestimating intracranial pressure by more than 10 mm Hg and the possibility of significant drifting of EDP over time, which argues against the use of this method even tor trend analysis.

Journal

NeurosurgeryOxford University Press

Published: Aug 1, 1998

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial