| Intracranial pressure-monitoring systems in children with traumatic brain injury: Combining therapeutic and diagnostic tools. | |
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MedLine Citation:
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PMID: 20625341 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: : To compare the correlation of intracranial pressure (ICP) measurement and time to detection of ICP crises (defined as ICP ≥20 mm Hg for ≥5 mins) between an intraparenchymal (IP) monitor and external ventricular drain (EVD) in children for whom continuous cerebrospinal fluid diversion was used as a therapy for severe traumatic brain injury. SETTING: : Academic, pediatric intensive care unit. DESIGN: : Retrospective review of a prospectively collected pediatric neurotrauma database. PATIENTS: : Children with severe traumatic brain injury (Glasgow Coma Scale score of ≤8) who underwent ICP monitoring with both IP and EVD techniques were studied. In cohort 1 (n = 58), hourly ICP measurements were extracted from the medical record; in cohort 2 (n = 4), ICP measurements were collected every minute by an automated data-collection system. MEASUREMENTS AND MAIN RESULTS: : The mean absolute difference in ICP (|N5ICP|N5) and intraclass correlation coefficients were calculated. Timing to detection of ICP crises was analyzed. Data were expressed as mean ± sem. For cohort 1, 7,387 hrs of data were analyzed; 399 hrs (23,940 mins) were analyzed for cohort 2. In cohort 1, the |N5ICP|N5 was 3.10 ± 0.04 mm Hg (intraclass correlation coefficients = 0.98, p < .001). The |N5ICP|N5 in cohort 2 was 3.30 ± 0.05 mm Hg (intraclass correlation coefficients = 0.98, p < .001). In cohort 2, a total of 75 ICP crises were observed. Fifty-five (73%) were detected first by the IP monitor, of which 35 were not identified by the EVD monitor. Time between IP and EVD detection of a crisis was 12.60 ± 2.34 mins. CONCLUSION: : EVD and IP measurements of ICP were highly correlated, although intermittent EVD ICP measurements may fail to identify ICP events when continuously draining cerebrospinal fluid. In institutions that use continuous cerebrospinal fluid diversion as a therapy, a two-monitor system may be valuable for accomplishing monitoring and therapeutic goals. |
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Authors:
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Jennifer Exo; Patrick M Kochanek; P David Adelson; Stephanie Greene; Robert S B Clark; Hülya Bayir; Stephen R Wisniewski; Michael J Bell |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: 12 ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 560-5 Citation Subset: IM |
Affiliation:
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From the Departments of Critical Care Medicine (JE, PMK, RSBC, HB, MJB), Neurological Surgery (SG, MJB), Epidemiology and Biostatistics (SRW), and the Safar Center for Resuscitation Research (PMK, RSBC, HB, MJB), University of Pittsburgh School of Medicine, Pittsburgh, PA; and the Department of Neurological Surgery (PDA), Phoenix Children's Hospital, Phoenix, AZ. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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