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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
Stefan Wolf, Ludwig Schürer, Doortje C Engel
OBJECTIVE: Brain tissue oxygenation (pbt O2 ) monitoring with microprobes is increasingly used as an important parameter in addition to intracranial pressure in acutely brain-injured patients. Data on accuracy and long-term drift after use are scarce. We investigated room air readings of used pbt O2 probes for their relationship with the duration of monitoring, geographic location of the center, and manufacturer type. METHODS: After finishing clinically indicated monitoring in patients, pbt O2 probes used in two centers in Berlin and Munich were explanted and cleaned to avoid blood contamination...
2018: Acta Neurochirurgica. Supplement
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
L G Petersen, J C G Petersen, M Andresen, N H Secher, M Juhler
We evaluated postural effects on intracranial pressure (ICP) and cerebral perfusion pressure [CPP: mean arterial pressure (MAP) - ICP] in neurosurgical patients undergoing 24-h ICP monitoring as part of their diagnostic workup. We identified nine patients (5 women, age 44 ± 20 yr; means ± SD), who were "as normal as possible," i.e., without indication for neurosurgical intervention (e.g., focal lesions, global edema, abnormalities in ICP-profile, or cerebrospinal fluid dynamics). ICP (tip-transducer probe; Raumedic) in the brain parenchyma (n = 7) or in the lateral ventricles (n = 2) and cardiovascular variables (Nexfin) were determined from 20° head-down tilt to standing up...
January 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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
Julian Kuenzel, Klaudija Geisler, Olga Strahl, Philipp Grundtner, Matthias W Beckmann, Ralf Dittrich
OBJECTIVE: The herbal agent celandine is thought to have mainly spasmolytic effects, but in the uterus it is regarded as promoting contractions, which can offer promising and innovative options for optimizing artificial reproduction. The aim of the present study was to investigate the effect of celandine on the uterine muscle, using a perfusion model of swine uteri. STUDY DESIGN: Sixteen swine uteri were perfused with Krebs-Ringer solution. Celandine (Chelidonium, Paverysat; Johannes Bürger Ysatfabrik Ltd...
July 2013: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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
Melanie Schmitt, Regina Eymann, Sebastian Antes, Michael Kiefer
We implemented ventricular infusion studies on 33 patients suspected of idiopathic normal pressure hydrocephalus (iNPH), benign intracranial hypertension (BIH) or occlusive hydrocephalus (HOC) in order to confirm shunt indications. The initial scope was to study O(2) supply during infusion tests to exclude further violation of already vulnerable brains during ICP elevation. Intraventricular infusion was performed via ventricle catheters with the ICP tip sensor, while brain tissue oxygenation was measured with intraparenchymal Raumedic PTO probes...
2012: Acta Neurochirurgica. Supplement
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
Stefan Wolf, P Horn, C Frenzel, L Schürer, P Vajkoczy, J Dengler
INTRODUCTION: Continuous bedside brain tissue oxygenation (p(br)O(2)) monitoring using the Licox system is an established method for detecting secondary ischemia in comatose patients with acute brain injury. The purpose of the current study was to compare the newly introduced Raumedic p(br)O(2) probe with the established standard. METHODS: Eighteen patients with acute traumatic brain injury or aneurysmal subarachnoid hemorrhage had p(br)O(2) probes of both types implanted side by side in the same vascular territory at risk of ischemia...
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
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
Melanie Schmitt, Regina Eymann, Sebastian Antes, Michael Kiefer
We established a CE-certified telemetric device to measure intracranial pressure (ICP) noninvasively. To evaluate whether subdural or intraparenchymal insertion of such devices should be preferred, we implanted these telemetric ICP measurement devices (Raumedic, Rautel) in both locations. The study was performed in nine minipigs. The telemetric data were validated every 3 months using conventional intraparenchymal ICP measurement probes.The intraparenchymal telemetric device failed in one animal 12 months after insertion...
2012: Acta Neurochirurgica. Supplement
Petra Schödel, Martin Proescholdt, Odo-Winfried Ullrich, Alexander Brawanski, Karl-Michael Schebesch
Burr-hole trephine and insertion of external ventricular drainage (EVD) is the most common neurosurgical treatment of acute hydrocephalus. Until 2005, we performed this procedure conventionally in the operating room (OR) using a mechanical drill but in 2004 we started to use a manual drill and a skull screw (Bolt Kit System [BKS], Raumedic, Münchberg, Germany) for creating burr-holes in the Intensive Care Unit (ICU) exclusively. This retrospective study compares the outcomes after both surgical procedures of 312 consecutive patients (190 patients, conventional procedure; 122, the BKS system; total female 171, male 141; mean age 59...
February 2012: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Petra Schödel, Martin Proescholdt, Alexander Brawanski, Sylvia Bele, Karl-Michael Schebesch
INTRODUCTION: Burr-hole trephine and insertion of an external ventricular drainage (EVD) is a common procedure in neurosurgical practice. In critically ill patients, the transport to the operating room, OR represents a major risk. Thus, the burr-hole trephine and implantation of an EVD is frequently performed on the Intensive Care Unit (ICU). Since 2004, we have applied two different procedures: the conventional method with a mechanical compressed air or an electric drill, and an alternative method with a manual twist drill, including fixation of the EVD in a skull screw (Bolt Kit, Raumedic AG, Germany)...
April 2012: British Journal of Neurosurgery
Per K Eide, André Bakken
BACKGROUND: The monitoring of intracranial pressure (ICP) has a crucial role in the surveillance of patients with brain injury. During long-term monitoring of ICP, we have seen spontaneous shifts in baseline pressure (ICP sensor zero point), which are of technical and not physiological origin. The aim of the present study was to explore whether or not baseline pressures of ICP sensors can be affected by electrostatics discharges (ESD's), when ESD's are delivered at clinically relevant magnitudes...
2011: Biomedical Engineering Online
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