gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Measurement of brain tissue oxygen, brain temperature and intracranial pressure – Evaluation of a multiparameter neuromonitoring device

Meeting Abstract

Suche in Medline nach

  • C. Hohaus - BG Klinik Bergmannstrost Halle, Klinik für Neurochirurgie
  • B.C. Kern - BG Klinik Bergmannstrost Halle, Klinik für Neurochirurgie
  • H.J. Meisel - BG Klinik Bergmannstrost Halle, Klinik für Neurochirurgie
  • G. Huschak - Universitätsklinikum Leipzig, Klinik für Anästhesiologie und Intensivmedizin

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.06.08

DOI: 10.3205/11dgnc036, URN: urn:nbn:de:0183-11dgnc0366

Veröffentlicht: 28. April 2011

© 2011 Hohaus et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Continuous monitoring of intracranial pressure (ICP) and partial pressure of brain tissue oxygen (ptiO2) is being used increasingly in critical patients suffering from severe acute brain disease. The presented study evaluated the first controlled clinical use of a multiparameter catheter (Neurovent PTO) measuring ICP, ptiO2 and brain temperature (TBr). To assess the validity of measured ptiO2 a second probe (Licox), which represents the current standard of ptiO2 measurement, was implanted.

Methods: Thirty patients with indicated invasive measurement of ICP under intensive care unit conditions were included. Using a double lumen bolt, ptiO2 was measured simultaneously with Licox and Neurovent PTO. The manufacturer of the Neurovent PTO conducted ex vivo tests on both probes independently.

Results: The average of individual mean ptiO2 measurements showed no relevant differences between the Licox (19.5 ± 7.1) and the Neurovent multiparameter probe (21.7 ± 9.5). Twenty-eight Licox probes out of 30 showed proper functioning over the desired monitoring period. Raumedic multiparameter probes displayed a higher error frequency. A comparison of the ptiO2 data between the Licox and Raumedic systems according to Bland and Altman was possible in 18 out of 30 patients and showed acceptable results (mean difference –1.24 mm Hg; limits of agreement: –25.1 to +22.6 mm Hg). A total of 95.2% of 96,083 recordings was within the calculated limits of agreement. Ex vivo tests of the probes after explantation revealed stable ICP and TBr function of the Raumedic probe. Precision of Zero ptiO2 did not differ between the probes, whereas precision of the 150mm Hg ptiO2 was greater in the Raumedic probes.

After finding the higher frequency in mechanical error rate, the design of the multiparameter probe was changed by the manufacturer. The technical details were not changed. The mechanical stability clearly improved. No more mechanical errors were observed using the next 15 probes.

Conclusions: Combining 3 different neuromonitoring functions in 1 probe is technical possible and might ease monitoring by making a second (ptiO2) probe unnecessary. In comparison with the current standard probe (Licox), the multiparameter probe showed similar mean ptiO2 values.

The initial findings concerning higher mechanical failure of the Neurovent PTO were not longer observed after changing the design.