Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2012
Bioinformatics analysis of mortality associated with elevated intracranial pressure in children.
Multivariate data analyses have the potential to enrich the use of the complex plethora of data gathered in the care of critically ill patients. We sought to apply hierarchical cluster analysis to investigate factors affecting outcome in children with acute brain injury requiring ICP monitoring. ⋯ The dose of abnormal ICP may contribute to outcome in insults that involve increased ICP. These results are proof of principle of the potential application of hierarchical clustering to the clinical practice of pediatric neurocritical care.
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Acta Neurochir. Suppl. · Jan 2012
The impact of silver nanoparticle-coated and antibiotic-impregnated external ventricular drainage catheters on the risk of infections: a clinical comparison of 95 patients.
Infection, i.e. meningitis or ventriculitis, is a major complication of external ventricular drainage (EVD). In order to prevent this complication rifampin-impregnated and clindamycin-impregnated silicone catheters and EVDs impregnated with nanoparticles of silver and an insoluble silver salt have been developed. Sparse data are published concerning the efficacy of these catheters in reducing bacterial colonization. ⋯ Rifampin-impregnated and clindamycin-impregnated EVDs as well as silver-impregnated EVDs decreased the infection rate. Randomized studies are needed to assess the advantage of these catheters compared with standard polyurethane catheters.
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Acta Neurochir. Suppl. · Jan 2012
Shunt-dependent hydrocephalus following subarachnoid hemorrhage correlates with increased S100B levels in cerebrospinal fluid and serum.
Posthemorrhagic hydrocephalus requiring permanent ventriculoperitoneal shunt placement is a major complication of aneurysmal subarachnoid hemorrhage (SAH). High S100B serum and cerebrospinal fluid (CSF) levels are considered to reflect the severity of brain injury. We prospectively assessed whether S100B levels in serum and CSF were predictive parameters for permanent shunt requirement following aneurysmal SAH. ⋯ Out of 68 patients included in the study, 43 patients (63.2%) passed the EVD challenge and in 25 patients (36.8%) permanent ventriculoperitoneal shunting was performed. Group comparison revealed that in patients who required shunt placement, S100B was significantly higher in CSF (p < 0.05 at days 2, 4, 6, 10; p < 0.005 at days 1, 3, 5, 7, 8, 9) and serum (p < 0.05 at days 4-7) compared with patients who could be weaned from the EVD. Assessment of S100B levels in CSF and serum may be useful as a predictive parameter for shunt dependency in patients with posthemorrhagic hydrocephalus following aneurysmal SAH.
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Acta Neurochir. Suppl. · Jan 2012
Intracranial pressure telemetry: first experience of an experimental in vivo study using a new device.
To test two new telemetric intracranial pressure (ICP) probes (NEUROVENT(®)-P-tel, NEUROVENT(®)-S-tel) in a porcine model. We aimed to intraoperatively correlate the telemetric probes to parenchymal ICP probes and study their reliability in the first hours after implantation. The experimental set-up, new telemetric technology and first data will be presented. ⋯ We present a new telemetric technology that was experimentally compared with a parenchymal ICP probe. We provide data that the new telemetric probes will comparably measure ICP vs an external ICP probe. This stand-alone ICP tool may allow permanent measurement of ICP in hydrocephalus patients. Further continuation of our study will demonstrate whether this system guarantees acceptable long-term reliability.
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Acta Neurochir. Suppl. · Jan 2012
Is P(br)O (2) pressure reactivity index (ORx) dependent on the type of oxygen probe? An in vivo study.
To evaluate if ORx is dependent on the type of brain tissue O(2) (P(br)O(2)) probe in an in vivo setting. ⋯ Despite this significant difference in absolute values of P(br)O(2) the derived mean ORx values were not different. Similar to the established Licox system, the Raumedic system seems to enable a valid ORx recording.