Picard P, Waleckx P, Bonnard-Gougeon M, Sinardet D, Lemaire J J, Chazal J
Département d'anesthésie-réanimation, CHRU, hôpital de Fontmaure, Chamalières, France.
Ann Fr Anesth Reanim. 1997;16(4):420-8. doi: 10.1016/s0750-7658(97)81474-8.
To assess the use of ICP monitoring in France and French-speaking Belgium and Switzerland.
Neuro-intensive care unit (ICU) and neuroanaesthesia teams.
Retrospective survey (concerning the year 1995), followed by a prospective one (spread over a period of 4 months in 1996) about policy concerning: frequency, delay, duration, indications, complications and cost of ICP monitoring in their units. Other questions were: type of devices, duration of the device insertion, operators and place of operating.
Out of the 77 units which replied, 54 regularly carried out ICP monitoring, corresponding to a total of 2,012 patients in 1995. Only 23 participated in the prospective survey (301 patients). Out of the 54 hospitals, 25 assessed the ICP in more than 50 patients per year. Head trauma was the main indication for ICP monitoring (61%), the second indication was intracranial haemorrhage (23% of patients). The most often monitored patients were young males for head trauma, whereas females were mainly monitored for intracranial haemorrhage. The delay for starting ICP monitoring was 16 hours and was maintained for 7 days in head trauma patients. Intraventricular catheter and fibreoptic devices were chosen in the same proportion, a subdural system was used in 8% of the cases. The devices were inserted by neurosurgeons in 80% of cases, anaesthetists also participated in this operation. Risk of haemorrhage was very low (0.7%), the risk of infection was 4% and always concerned intraventricular catheters.
ICP monitoring is widely practised in France and French-speaking Belgium and Switzerland, especially for traumatic brain injury in young males. Anaesthetists mainly took part in the operation, especially for the fibreoptic devices.
评估法国以及法语区的比利时和瑞士颅内压监测的使用情况。
神经重症监护病房（ICU）和神经麻醉团队。
进行回顾性调查（涉及1995年），随后进行前瞻性调查（在1996年为期4个月的时间段内展开），内容涉及各单位关于颅内压监测的频率、延迟时间、持续时间、适应证、并发症及费用等政策。其他问题包括：设备类型、设备插入持续时间、操作人员及操作地点。
在回复的77个单位中，54个单位常规进行颅内压监测，1995年总计有2012例患者。仅有23个单位参与了前瞻性调查（301例患者）。在54家医院中，25家每年评估颅内压的患者超过50例。颅脑外伤是颅内压监测的主要适应证（61%），第二大适应证是颅内出血（占患者的23%）。因颅脑外伤接受监测的患者中，最常被监测的是年轻男性，而女性主要因颅内出血接受监测。颅脑外伤患者开始颅内压监测的延迟时间为16小时，持续7天。脑室内导管和光纤设备的选择比例相同，8%的病例使用了硬膜下系统。80%的病例由神经外科医生插入设备，麻醉医生也参与了此项操作。出血风险非常低（0.7%），感染风险为4%，且总是与脑室内导管相关。
颅内压监测在法国以及法语区的比利时和瑞士广泛应用，尤其是针对年轻男性的创伤性脑损伤。麻醉医生主要参与操作，特别是对于光纤设备。
