Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?
Identifieur interne : 000053 ( Main/Curation ); précédent : 000052; suivant : 000054Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?
Auteurs : Lars-Owe D. Koskinen [Suède] ; Jan Malm [Suède] ; Rolandas Zakelis [Lituanie] ; Laimonas Bartusis [Lituanie] ; Arminas Ragauskas [Lituanie] ; Anders Eklund [Suède]Source :
- Journal of clinical monitoring and computing [ 1573-2614 ] ; 2016.
Abstract
Measurement of intracranial pressure (ICP) is necessary in many neurological and neurosurgical diseases. To avoid lumbar puncture or intracranial ICP probes, non-invasive ICP techniques are becoming popular. A recently developed technology uses two-depth Doppler to compare arterial pulsations in the intra- and extra-cranial segments of the ophthalmic artery for non-invasive estimation of ICP. The aim of this study was to investigate how well non-invasively-measured ICP and invasively-measured cerebrospinal fluid (CSF) pressure correlate. We performed multiple measurements over a wide ICP span in eighteen elderly patients with communicating hydrocephalus. As a reference, an automatic CSF infusion apparatus was connected to the lumbar space. Ringer's solution was used to create elevation to pre-defined ICP levels. Bench tests of the infusion apparatus showed a random error (95 % CI) of less than ±0.9 mmHg and a systematic error of less than ±0.5 mmHg. Reliable Doppler signals were obtained in 13 (72 %) patients. An infusion test could not be performed in one patient. Thus, twelve patients and a total of 61 paired data points were studied. The correlation between invasive and non-invasive ICP measurements was good (R = 0.74), and the 95 % limits of agreements were -1.4 ± 8.8 mmHg. The within-patient correlation varied between 0.47 and 1.00. This non-invasive technique is promising, and these results encourage further development and evaluation before the method can be recommended for use in clinical practice.
DOI: 10.1007/s10877-016-9862-4
PubMed: 26971794
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Koskinen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Neuroscience, Neurosurgery and Neurology, Umeå University, Umeå, 90185, Sweden. Lars-Owe.Koskinen@umu.se.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Neurosurgery and Neurology, Umeå University, Umeå, 90185</wicri:regionArea><wicri:noRegion>90185</wicri:noRegion></affiliation></author><author><name sortKey="Malm, Jan" sort="Malm, Jan" uniqKey="Malm J" first="Jan" last="Malm">Jan Malm</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Neuroscience, Neurosurgery and Neurology, Umeå University, Umeå, 90185, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Neuroscience, Neurosurgery and Neurology, Umeå University, Umeå, 90185</wicri:regionArea><wicri:noRegion>90185</wicri:noRegion></affiliation></author><author><name sortKey="Zakelis, Rolandas" sort="Zakelis, Rolandas" uniqKey="Zakelis R" first="Rolandas" last="Zakelis">Rolandas Zakelis</name><affiliation wicri:level="1"><nlm:affiliation>Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.</nlm:affiliation><country xml:lang="fr">Lituanie</country><wicri:regionArea>Health Telematics Science Institute, Kaunas University of Technology, Kaunas</wicri:regionArea><wicri:noRegion>Kaunas</wicri:noRegion></affiliation></author><author><name sortKey="Bartusis, Laimonas" sort="Bartusis, Laimonas" uniqKey="Bartusis L" first="Laimonas" last="Bartusis">Laimonas Bartusis</name><affiliation wicri:level="1"><nlm:affiliation>Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.</nlm:affiliation><country xml:lang="fr">Lituanie</country><wicri:regionArea>Health Telematics Science Institute, Kaunas University of Technology, Kaunas</wicri:regionArea><wicri:noRegion>Kaunas</wicri:noRegion></affiliation></author><author><name sortKey="Ragauskas, Arminas" sort="Ragauskas, Arminas" uniqKey="Ragauskas A" first="Arminas" last="Ragauskas">Arminas Ragauskas</name><affiliation wicri:level="1"><nlm:affiliation>Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.</nlm:affiliation><country xml:lang="fr">Lituanie</country><wicri:regionArea>Health Telematics Science Institute, Kaunas University of Technology, Kaunas</wicri:regionArea><wicri:noRegion>Kaunas</wicri:noRegion></affiliation></author><author><name sortKey="Eklund, Anders" sort="Eklund, Anders" uniqKey="Eklund A" first="Anders" last="Eklund">Anders Eklund</name><affiliation wicri:level="1"><nlm:affiliation>Department Radiation Sciences - Biomedical Engineering, Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department Radiation Sciences - Biomedical Engineering, Umeå University, Umeå</wicri:regionArea><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of clinical monitoring and computing</title><idno type="eISSN">1573-2614</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Measurement of intracranial pressure (ICP) is necessary in many neurological and neurosurgical diseases. To avoid lumbar puncture or intracranial ICP probes, non-invasive ICP techniques are becoming popular. A recently developed technology uses two-depth Doppler to compare arterial pulsations in the intra- and extra-cranial segments of the ophthalmic artery for non-invasive estimation of ICP. The aim of this study was to investigate how well non-invasively-measured ICP and invasively-measured cerebrospinal fluid (CSF) pressure correlate. We performed multiple measurements over a wide ICP span in eighteen elderly patients with communicating hydrocephalus. As a reference, an automatic CSF infusion apparatus was connected to the lumbar space. Ringer's solution was used to create elevation to pre-defined ICP levels. Bench tests of the infusion apparatus showed a random error (95 % CI) of less than ±0.9 mmHg and a systematic error of less than ±0.5 mmHg. Reliable Doppler signals were obtained in 13 (72 %) patients. An infusion test could not be performed in one patient. Thus, twelve patients and a total of 61 paired data points were studied. The correlation between invasive and non-invasive ICP measurements was good (R = 0.74), and the 95 % limits of agreements were -1.4 ± 8.8 mmHg. The within-patient correlation varied between 0.47 and 1.00. This non-invasive technique is promising, and these results encourage further development and evaluation before the method can be recommended for use in clinical practice.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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