Comparison of intracranial pressure and pressure reactivity index obtained through pressure measurements in the ventricle and in the parenchyma during and outside cerebrospinal fluid drainage episodes in a manipulation-free patient setting

Samuel Patrick Klein, Dominike Bruyninckx, Ina Callebaut, Bart Depreitere

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations

Abstract

Objective: We investigated the effect of cerebrospinal fluid (CSF) drainage on the intracranial pressure (ICP) signal measured in the parenchyma and the ventricle as well as the effect on the pressure reactivity index (PRx) calculated from both signals. Methods: Ten patients were included in this prospective study. All patients received a parenchymal ICP sensor and an external ventricular drain (EVD) for CSF drainage. ICP signals (ICP-p and ICP-evd) were captured. Part of the study was a period of 90 min during which the patient was free from any manipulation, consisting of 30 min of drainage (O1), 30 min EVD closed (C) and 30 min of drainage (O2). Results: Mean ICP-evd and mean AMP-evd increased (3.03 and 0.46 mmHg) from O1 to C and decreased (2.12 and 0.43 mmHg) from C to O2. ICP-p and AMP-p changes were less pronounced (closing EVD: +0.81 mmHg/+0.22 mmHg; opening EVD: −0.22 mmHg/−0.05 mmHg). Mean difference between PRx-evd and PRx-p was 0.12 for O1, 0.02 for C and −0.02 for O2. The intraclass correlation coefficient for absolute agreement of single measures was 0.66 for O1, 0.77 for C and 0.69 for O2. Mean PRx differences demonstrated a significant difference between O1 versus C and O1 versus O2 but not between C versus O2. Conclusion: Drainage of CSF reduces ICP magnitude and amplitude through the EVD. This effect was only marginal in parenchymal ICP measurements. In manipulation-free circumstances, agreement of PRx obtained through parenchymal and ventricular measurements was moderate to good, depending on the statistical method, and was not necessarily influenced by drainage.

Original languageEnglish
Title of host publicationActa Neurochirurgica, Supplementum
PublisherSpringer-Verlag Wien
Pages287-290
Number of pages4
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Publication series

NameActa Neurochirurgica, Supplementum
Volume126
ISSN (Print)0065-1419
ISSN (Electronic)2197-8395

Keywords

  • Autoregulation
  • Cerebrospinal fluid drainage
  • External ventricular drain
  • Intracranial pressure

Fingerprint Dive into the research topics of 'Comparison of intracranial pressure and pressure reactivity index obtained through pressure measurements in the ventricle and in the parenchyma during and outside cerebrospinal fluid drainage episodes in a manipulation-free patient setting'. Together they form a unique fingerprint.

  • Cite this