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Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
March 16, 2018: Journal of Neurotrauma
Annika Nelskylä, Jouni Nurmi, Milla Jousi, Alexey Schramko, Eero Mervaala, Giuseppe Ristagno, Markus B Skrifvars
BACKGROUND AND AIM: We hypothesised that the use of 50% compared to 100% oxygen maintains cerebral oxygenation and ameliorates the disturbance of cardiac mitochondrial respiration during cardiopulmonary resuscitation (CPR). METHODS: Ventricular fibrillation (VF) was induced electrically in anaesthetised healthy adult pigs and left untreated for seven minutes followed by randomisation to manual ventilation with 50% or 100% oxygen and mechanical chest compressions (LUCAS® )...
July 2017: Resuscitation
Sebastian Antes, Christoph A Tschan, Michael Heckelmann, David Breuskin, Joachim Oertel
BACKGROUND: Devices enabling long-term intracranial pressure monitoring have been demanded for some time. The first solutions using telemetry were proposed in 1967. Since then, many other wireless systems have followed but some technical restrictions have led to unacceptable measurement uncertainties. In 2009, a completely revised telemetric pressure device called Neurovent P-tel was introduced to the market. This report reviews technical aspects, handling, possibilities of data analysis, and the efficiency of the probe in clinical routine...
July 2016: World Neurosurgery
Sara Magnéli, Timothy Howells, Daniel Saiepour, Daniel Nowinski, Per Enblad, Pelle Nilsson
INTRODUCTION: There are no reliable noninvasive methods of monitoring ICP. Most assessments are made by indirect measures and are difficult to follow over time. Invasive studies can be used but up until now have required in-hospital transcutaneous measurements. Accurate ICP recordings over longer periods of time can be very valuable in timing different surgical procedures in syndromal cases. This case shows that telemetric ICP monitoring can be used for long-term follow-up in patients that may need repeated surgeries related to their craniosynostosis condition...
July 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Thien-Tri Cung, Olivier Morel, Guillaume Cayla, Gilles Rioufol, David Garcia-Dorado, Denis Angoulvant, Eric Bonnefoy-Cudraz, Patrice Guérin, Meier Elbaz, Nicolas Delarche, Pierre Coste, Gerald Vanzetto, Marc Metge, Jean-François Aupetit, Bernard Jouve, Pascal Motreff, Christophe Tron, Jean-Noel Labeque, Philippe Gabriel Steg, Yves Cottin, Grégoire Range, Jérome Clerc, Marc J Claeys, Patrick Coussement, Fabrice Prunier, Frédéric Moulin, Olivier Roth, Loïc Belle, Philippe Dubois, Paul Barragan, Martine Gilard, Christophe Piot, Patrice Colin, Fabien De Poli, Marie-Claude Morice, Omar Ider, Jean-Luc Dubois-Randé, Thierry Unterseeh, Hervé Le Breton, Thierry Béard, Didier Blanchard, Gilles Grollier, Vincent Malquarti, Patrick Staat, Arnaud Sudre, Eskil Elmer, Magnus J Hansson, Cyrille Bergerot, Inesse Boussaha, Claire Jossan, Geneviève Derumeaux, Nathan Mewton, Michel Ovize
BACKGROUND: Experimental and clinical evidence suggests that cyclosporine may attenuate reperfusion injury and reduce myocardial infarct size. We aimed to test whether cyclosporine would improve clinical outcomes and prevent adverse left ventricular remodeling. METHODS: In a multicenter, double-blind, randomized trial, we assigned 970 patients with an acute anterior ST-segment elevation myocardial infarction (STEMI) who were undergoing percutaneous coronary intervention (PCI) within 12 hours after symptom onset and who had complete occlusion of the culprit coronary artery to receive a bolus injection of cyclosporine (administered intravenously at a dose of 2...
September 10, 2015: New England Journal of Medicine
Karlis Purins, Anders Lewén, Lars Hillered, Tim Howells, Per Enblad
INTRODUCTION: Neurointensive care of traumatic brain injury (TBI) patients is currently based on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targeted protocols. There are reasons to believe that knowledge of brain tissue oxygenation (BtipO2) would add information with the potential of improving patient outcome. The aim of this study was to examine BtipO2 and cerebral metabolism using the Neurovent-PTO probe and cerebral microdialysis (MD) in TBI patients. METHODS: Twenty-three severe TBI patients with monitoring of physiological parameters, ICP, CPP, BtipO2, and MD for biomarkers of energy metabolism (glucose, lactate, and pyruvate) and cellular distress (glutamate, glycerol) were included...
2014: Frontiers in Neurology
Alexander Lilja, Morten Andresen, Amer Hadi, Dorthe Christoffersen, Marianne Juhler
BACKGROUND: Monitoring of intracranial pressure (ICP) is important in the optimal treatment of various neurological and neurosurgical diseases. Telemetric ICP monitoring allows long-term measurements in the patient's everyday life and the possibility to perform additional measurements without the procedure related risks of repeated transducer insertions. MATERIALS AND METHODS: We identified all patients in our clinic with an implanted Raumedic(®) telemetric ICP probe (NEUROVENT(®)-P-tel)...
May 2014: Clinical Neurology and Neurosurgery
Florian Baptist Freimann, Matthias Schulz, Hannes Haberl, Ulrich-Wilhelm Thomale
OBJECT: The advances in shunt valve technology towards modern adjustable differential pressure (DP) valves and adjustable gravitational assisted valves result in an increasing complexity of therapeutical options. Modern telemetric intracranial pressure (ICP) sensors may be helpful in their application for diagnostic purposes in shunt therapy. We present our first experiences on telemetric ICP-guided valve adjustments in cases with the combination of an adjustable DP valve and adjustable gravitational unit...
April 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Florian Baptist Freimann, Christian Sprung, Sascha Santosh Chopra, Peter Vajkoczy, Stefan Wolf
The Neurovent-P-tel sensor is a promising device for telemetric intracranial pressure (ICP) measurements in cases of complex hydrocephalus. Data on its accuracy within a broad ICP range are missing. We applied a porcine model for large-scale manipulation of the ICP values. The telemetric ICP sensor was referenced against ICP values measured directly from a water column within a riser tube. A total of 34 comparative ICP measurements within an ICP range from 2 cm H2O to 31 mm Hg were performed. The mean difference between both measurement techniques was 0...
2013: Pediatric Neurosurgery
Julius Dengler, Christin Frenzel, Peter Vajkoczy, Peter Horn, Stefan Wolf
BACKGROUND: The oxygen reactivity index (ORx) has been introduced to assess the status of cerebral autoregulation after traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Currently, there is some controversy about whether the ORx depends on the type of PbrO2-sensor technology used for its calculation. To examine if the probe technology does matter, we compared the ORx and the resulting optimal cerebral perfusion pressures (CPPopt) of simultaneously implanted Licox (CC1.SB, Integra Neuroscience, France) and Neurovent-PTO (Raumedic, Germany) probes in patients after aneurysmal SAH or severe TBI...
August 2013: Neurocritical Care
G Grözinger, Martin Schenk, Christian Thiel, Karolin Thiel, Matthias H Morgalla, Martin U Schuhmann
OBJECTIVE: To evaluate if ORx is dependent on the type of brain tissue O(2) (P(br)O(2)) probe in an in vivo setting. METHODS: In eight German landrace pigs two types of probes were implanted simultaneously in the same cerebral hemisphere. All pigs underwent hepatectomy and received neuromonitoring until death. A LICOX(®) probe CCI.S, representing a Clarke type electrode, was compared with a Raumedic Neurovent PTO, representing an optode. Data were sampled at 50 Hz...
2012: Acta Neurochirurgica. Supplement
Matthias H Morgalla, R Haas, G Grözinger, Christian Thiel, Karolin Thiel, Martin U Schuhmann, Martin Schenk
BACKGROUND: Only a few experimental reports are available on the direct comparison of Licox(®) and Raumedic(®)-Neurovent-PTO brain tissue oxygen pressure (P(br)O(2)) monitors. We compared the two systems regarding their measurement properties under experimental in vitro and in vivo conditions. MATERIALS AND METHODS: Eight Licox(®) and Raumedic(®) Neurovent-PTO(®) sensors were tested for 10 min at 37°C, atmospheric pressure, at an oxygen content of 0% and 100% before and after the in vivo test...
2012: Acta Neurochirurgica. Supplement
M Dengl, M Jaeger, C Renner, J Meixensberger
We investigated two commercially available probes for measurement of the partial pressure of brain tissue oxygen (PbrO2) and calculation of the index of brain tissue oxygen pressure reactivity (ORx) in 7 patients after aneurysmal subarachnoid hemorrhage (SAH). Simultaneous monitoring of PbrO2 using the Licox(®) probe and the multiparameter Raumedic probe (Neurovent PTO(®)), measuring PbrO2, intracranial pressure (ICP) and brain temperature (Neurovent PTO) was performed for a median of 9 days (range 7-17 days)...
2012: Acta Neurochirurgica. Supplement
Michael Kiefer, Sebastian Antes, Steffen Leonhardt, Melanie Schmitt, Berk Orakcioglu, Oliver W Sakowitz, Regina Eymann
The objective was to evaluate the qualification of the new telemetric intracranial pressure (ICP) measurement (t-ICP) device Raumedic(®) NEUROVENT P-Tel and S-Tel. The proof of concept was examined in a pilot animal study measuring intraperitoneal pressure with a telemetric and a conventional ICP measurement probe at five rates for 1 h each. Moderate external pressure load allowed measuring values between 0 and 40 mmHg. To estimate long-term performance 18 t-ICP devices were implanted subdurally or intraparenchymally into minipigs...
2012: Acta Neurochirurgica. Supplement
Berk Orakcioglu, Christopher Beynon, Modar M Kentar, Regina Eymann, Michael Kiefer, Oliver W Sakowitz
OBJECTIVE: 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. METHODS: We implanted a right parietal (parenchymal) and left parietal (subdural) telemetric ICP probe in 13 Göttingen mini-pigs under general anaesthesia...
2012: Acta Neurochirurgica. Supplement
Karlis Purins, Per Enblad, Lars Wiklund, Anders Lewén
BACKGROUND: Neurointensive care of traumatic brain injury (TBI) patients is currently based on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targeted protocols. Monitoring brain tissue oxygenation (BtipO2) is of considerable clinical interest, but the exact threshold level of ischemia has been difficult to establish due to the complexity of the clinical situation. The objective of this study was to use the Neurovent-PTO (NV) probe, and to define critical cerebral oxygenation- and CPP threshold levels of cerebral ischemia in a standardized brain death model caused by increasing the ICP in pig...
June 2012: Neurocritical Care
Michael Kiefer, Sebastian Antes, Melanie Schmitt, Inga Krause, Regina Eymann
Telemetric intracranial pressure (ICP) monitoring has been a challenge throughout several decades. Major obstruction was to minimize zero drift of absolute pressure sensors. A new promising product demonstrating in-vitro excellent long-term stability has been tested for its reliability in an animal model with a follow-up of up to 2 years. In "minipigs" sub-dural (Raumedic-STel®, Helmbrechts Germany) and intraparenchymal (Raumedic-PTel®) telemetric ICP probes have been inserted. Standard ICP probes (Raumedic Neurovent P®) served as controls...
2011: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Julius Dengler, Christin Frenzel, Peter Vajkoczy, Stefan Wolf, Peter Horn
PURPOSE: Cerebral tissue oxygenation (PbrO(2)) is most frequently monitored using a Licox CC1.SB system (LX, Integra Neuroscience, France) but recently a new probe--the Neurovent-PTO (NV)--was introduced by a different manufacturer (Raumedic, Germany). There are no prospective data on how these probes compare in clinical routine. We therefore compared both probes in comatose patients suffering from traumatic brain injury (TBI) or subarachnoid haemorrhage (SAH) during dynamic changes of inspirational oxygen fraction (FiO(2)) and mean arterial pressure (MAP)...
November 2011: Intensive Care Medicine
Berk Orakcioglu, Oliver W Sakowitz, Jan-Oliver Neumann, Modar M Kentar, Andreas Unterberg, Karl L Kiening
BACKGROUND: Cerebral microdialysis, cerebral blood flow, and cerebral oxygenation (PbrO2) measurements using intraparenchymal probes are widely accepted as invasive diagnostic monitoring for early detection of secondary ischemia. OBJECTIVE: To evaluate a novel PbrO2 probe for continuous and quantitative oxygenation assessment compared with the existing gold standard PbrO2 probe. METHODS: In 9 pigs, 2 PbrO2 probes (Neurovent-TO vs Licox) were implanted into the subcortical white matter...
December 2010: Neurosurgery
Karlis Purins, Per Enblad, Bo Sandhagen, Anders Lewén
OBJECT: Periods of brain tissue ischemia are common after severe head injury, and their occurrence and duration are negatively correlated with outcome. Accurate and reliable measurement of brain tissue oxygenation (B(ti) pO(2)) may be a key to improve patient outcome after severe head injury. Knowledge of stability and accuracy of the B(ti) pO(2) systems is crucial. We have therefore conducted a bench test study of new Neurovent-PTO (NV) and Licox (LX) oxygen tension catheters to evaluate the sensor accuracy, response time to different oxygen tensions, response to temperature changes and long-term stability...
April 2010: Acta Neurochirurgica
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