Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?

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...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 31; no. 2; pp. 459 - 468
Autores principales: Koskinen, Lars-Owe, Malm, Jan, Zakelis, Rolandas, Bartusis, Laimonas, Ragauskas, Arminas, Eklund, Anders, Koskinen, Lars-Owe D
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2017
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Can intracranial pressure be measured non-invasively bedside using a two-depth Doppler-technique?
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        au:
          Koskinen, Lars-Owe
          Malm, Jan
          Zakelis, Rolandas
          Bartusis, Laimonas
          Ragauskas, Arminas
          Eklund, Anders
          Koskinen, Lars-Owe D
        affil: Department of Clinical Neuroscience, Neurosurgery and Neurology , Umeå University , Umeå 90185 Sweden
      sug:
        subj:
          Intracranial Pressure
          Hydrocephalus, Normal Pressure
          Ultrasonography, Doppler Methods
          Ophthalmic Artery
          Ultrasonography, Doppler, Transcranial Methods
          Aged, 80 and Over
          Intracranial Hypertension
          Blood Pressure
          Hydrocephalus, Normal Pressure Physiopathology
          Reference Values
          Aged
          Linear Regression
          Female
          Reproducibility of Results
          Monitoring, Physiologic Methods
          Male
          Human
          Aged, 80 & over
          Aged: 65+ years
          Female
          Male
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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