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 ....
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Publisher
Oxford University Press
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

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