Codman微传感器颅内压监测系统的临床评估

Clinical evaluation of the Codman microsensor intracranial pressure monitoring system.

作者信息

Fernandes H M, Bingham K, Chambers I R, Mendelow A D

机构信息

Department of Neurosurgery, University of Newcastle-upon-Tyne, U.K.

出版信息

Acta Neurochir Suppl. 1998;71:44-6. doi: 10.1007/978-3-7091-6475-4_14.

DOI:10.1007/978-3-7091-6475-4_14

PMID:9779140

Abstract

INTRODUCTION

The use of the Camino fibre-optic subdural device for measuring Intracranial Pressure (ICP) in patients, has been shown to correlate well with recordings from the "gold standard" intraventricular fluid filled catheter [1]. Following this work, its use has become standard in the clinical monitoring of patients. More recently, laboratory studies have demonstrated accuracy, acceptable drift and high fidelity for the new Codman Microsensor ICP Transducer, a miniature strain gauge mounted on a flexible nylon catheter [3]. Its performance in patients, however, has yet to be fully assessed, in comparative studies.

METHODS

Eight patients (5 head injured, 3 with an Intracerebral haematoma) had a Codman Microsensor inserted. A Camino Transducer was fitted immediately adjacent to it. A computerised system was used to continuously record both ICP readings.

RESULTS

In total 140,323 recordings were made over a wide range of ICP values. Study periods ranged from 0.5 to 116 hours. In one patient the Codman transducer tracing failed after several days, probably due to fracture of electrical cable close to the interface box. The readings from the two ICP transducers were compared on Time Series, logistic regression and Altman-Bland plots. Drift of the ICP recorded by the Codman microsensor, was noted in 2 patients, 1 in positive direction (maximum 30 mmHg), 1 negative (max. 20 mmHg). In both cases the Camino ICP recording was relatively stable. In 24% of the recordings the Codman microsensor recorded ICP as 5 or more mmHg greater than the Camino, this difference was 10 mmHg or greater in 9% of recordings. Conversely the Camino recording was 5 mmHg or more, than the Codman, in 5% of all recordings, and 10 mmHg or more in 3%.

CONCLUSION

These differences could in the majority of cases (excepting the negative drift) be explained by a constant offset of the Codman transducer, as described previously [6]. Further examination of this device is required.

摘要

引言

已证明，使用卡米诺光纤硬膜下装置测量患者颅内压（ICP），与“金标准”的脑室内充液导管记录结果具有良好的相关性[1]。这项研究之后，其使用已成为患者临床监测的标准方法。最近，实验室研究表明，新型科德曼微传感器ICP换能器具有准确性、可接受的漂移和高保真度，该换能器是安装在柔性尼龙导管上的微型应变计[3]。然而，在比较研究中，其在患者中的性能尚未得到充分评估。

方法

8例患者（5例头部受伤，3例患有脑内血肿）插入了科德曼微传感器。在其紧邻位置安装了一个卡米诺换能器。使用计算机系统连续记录两个ICP读数。

结果

在广泛的ICP值范围内共进行了140323次记录。研究期从0.5小时到116小时不等。在一名患者中，科德曼换能器的记录在几天后失败，可能是由于靠近接口盒的电缆断裂。在时间序列、逻辑回归和奥特曼-布兰德图上比较了两个ICP换能器的读数。在2例患者中发现了科德曼微传感器记录的ICP漂移，1例为正向漂移（最大30 mmHg），1例为负向漂移（最大20 mmHg）。在这两种情况下，卡米诺ICP记录相对稳定。在24%的记录中，科德曼微传感器记录的ICP比卡米诺高5 mmHg或更多，在9%的记录中，这种差异为10 mmHg或更大。相反，在所有记录的5%中，卡米诺记录比科德曼高5 mmHg或更多，在3%中高10 mmHg或更多。