Abstract
IntroductionBoth ventricular and parenchymal devices are available for measurement of intracranial pressure (ICP). The Hummingbird® Synergy Ventricular System is a novel device allowing multi-parametric neurological monitoring, including both ventricular and parenchymal ICP. The purpose of this study is to compare the congruence of the device’s ventricular and parenchymal ICP readings.MethodsThis single-center, quantitative, interventional study compared parenchymal and ventricular ICP readings from 35 patients with the Hummingbird® System. If a difference of > ± 3 mmHg existed between an individual patient’s parenchymal and ventricular values, progressive intervention strategies were applied to correct identified issues.ResultsFrom a total of 2,259 observations, statistical analysis revealed congruence (within ±0-3 mmHg) of 93% of readings comparing parenchymal and ventricular ICP. Of the observations requiring intervention, 58% involved the parenchymal component, 30% involved the ventricular component, and 12% involved both components. Following prescribed interventions, 98% of readings became congruent (within ±0-3 mmHg). The adjusted mean difference between the two methods was -0.95 (95% CI: -0.97,-0.93) mmHg and all mean ICP readings fell between -2 and 2 mmHg.ConclusionThe Hummingbird® Synergy Ventricular System demonstrates congruence between ventricular and parenchymal ICP measurements within accepted parameters. Interventions required to realign parenchymal and ventricular readings serve as reminders to clinicians to be vigilant with catheter/cable connections and to maintain appropriate positioning of the ventricular drainage system. The results of this study support the recommendation to use the parenchymal ICP component for routine ICP monitoring, allowing dedication of the ventricular catheter to drainage of cerebrospinal fluid (CSF).
Highlights
Both ventricular and parenchymal devices are available for measurement of intracranial pressure (ICP)
Utilizing an air bladder technology for parenchymal ICP monitoring, this study showed good agreement between the readings from the Spiegelberg transducer with those from the ventricular drain (Chambers et al 2001)
To our knowledge, this study provides the first clinical data on the accuracy of the Hummingbird® ICP technology compared to standard ventricular ICP monitoring technology
Summary
Both ventricular and parenchymal devices are available for measurement of intracranial pressure (ICP). ICP monitoring and associated waveforms Prevention and control of increased ICP and maintenance of cerebral perfusion pressure (CPP) are fundamental therapeutic goals for critically ill neuroscience patients (Smith 2008). Both intraventricular and intraparenchymal devices are widely used in clinical practice for measuring. ICP monitoring devices measure the sum of the pressures exerted within the cranium by blood, brain, and cerebrospinal fluid (Littlejohns and Bader 2008). They transmit a waveform, representing the pressure pulse wave being transmitted into the intracranial compartment by systemic hemodynamics. The type of ICP monitoring device, the location in which it is placed, and the length of time implanted influence device functionality, accuracy, and incidence of complications (Littlejohns and Bader 2008)
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