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Pressure monitoring during neuroendoscopy : new insights

Frank Dewaele (UGent) , Alain Kalmar (UGent) , Koen Van Canneyt (UGent) , H Vereecke, A Absalom, Jacques Caemaert (UGent) , Michel Struys (UGent) and Dirk Van Roost (UGent)
(2011) BRITISH JOURNAL OF ANAESTHESIA. 107(2). p.218-224
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Organization
Abstract
Background. Significant increases in intracranial pressure (ICP) may occur during neuroendoscopic procedures. To detect and prevent serious and sustained increases, ICP should be monitored. At present, controversy exists on the optimal location of the monitoring sensor. Therefore, we conducted an in vitro study to estimate the pressure gradients between the ventricle, the 'gold standard' site, and the rinsing inlet and outlet. Methods. A head model and a standard endoscope were used. Rinsing was enforced by using a pressurized infusion bag. Using clinically relevant flow rates, pressure was measured at the rinsing inlet and outlet, in the ventricle, and at the distal end of the rinsing channel using a tip sensor or a capillary tube. Results. At a flow of 61 ml min(-1), the steady-state pressures measured at the rinsing inlet, in the ventricle, and at the rinsing outlet were 38, 26, and 12 mm Hg, respectively. At 135 ml min(-1), these increased to 136, 89, and 42 mm Hg. Transendoscopic pressure measurements were always within 1 mm Hg of the ventricular pressure. Conclusions. During endoscopy, measurements at the rinsing inlet overestimated the ventricular pressure by similar to 50 mm Hg during heavy rinsing, whereas measurements at the rinsing outlet underestimated the pressure by similar to 50 mm Hg. An electronic tip sensor or a pressure capillary tube placed at the distal end of the lumen of the rinsing channel of the endoscope did not interfere with rinsing flow and produced measurements that were equal to ventricular pressures.
Keywords
ENDOSCOPIC 3RD VENTRICULOSTOMY, INTRACRANIAL-PRESSURE, BRAIN ISCHEMIA, brain, HEMODYNAMICS, blood flow, intracranial pressure, monitoring, surgery, endoscopy, neurological

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MLA
Dewaele, Frank, Alain Kalmar, Koen Van Canneyt, et al. “Pressure Monitoring During Neuroendoscopy : New Insights.” BRITISH JOURNAL OF ANAESTHESIA 107.2 (2011): 218–224. Print.
APA
Dewaele, Frank, Kalmar, A., Van Canneyt, K., Vereecke, H., Absalom, A., Caemaert, J., Struys, M., et al. (2011). Pressure monitoring during neuroendoscopy : new insights. BRITISH JOURNAL OF ANAESTHESIA, 107(2), 218–224.
Chicago author-date
Dewaele, Frank, Alain Kalmar, Koen Van Canneyt, H Vereecke, A Absalom, Jacques Caemaert, Michel Struys, and Dirk Van Roost. 2011. “Pressure Monitoring During Neuroendoscopy : New Insights.” British Journal of Anaesthesia 107 (2): 218–224.
Chicago author-date (all authors)
Dewaele, Frank, Alain Kalmar, Koen Van Canneyt, H Vereecke, A Absalom, Jacques Caemaert, Michel Struys, and Dirk Van Roost. 2011. “Pressure Monitoring During Neuroendoscopy : New Insights.” British Journal of Anaesthesia 107 (2): 218–224.
Vancouver
1.
Dewaele F, Kalmar A, Van Canneyt K, Vereecke H, Absalom A, Caemaert J, et al. Pressure monitoring during neuroendoscopy : new insights. BRITISH JOURNAL OF ANAESTHESIA. 2011;107(2):218–24.
IEEE
[1]
F. Dewaele et al., “Pressure monitoring during neuroendoscopy : new insights,” BRITISH JOURNAL OF ANAESTHESIA, vol. 107, no. 2, pp. 218–224, 2011.
@article{1890287,
  abstract     = {Background. Significant increases in intracranial pressure (ICP) may occur during neuroendoscopic procedures. To detect and prevent serious and sustained increases, ICP should be monitored. At present, controversy exists on the optimal location of the monitoring sensor. Therefore, we conducted an in vitro study to estimate the pressure gradients between the ventricle, the 'gold standard' site, and the rinsing inlet and outlet. Methods. A head model and a standard endoscope were used. Rinsing was enforced by using a pressurized infusion bag. Using clinically relevant flow rates, pressure was measured at the rinsing inlet and outlet, in the ventricle, and at the distal end of the rinsing channel using a tip sensor or a capillary tube. Results. At a flow of 61 ml min(-1), the steady-state pressures measured at the rinsing inlet, in the ventricle, and at the rinsing outlet were 38, 26, and 12 mm Hg, respectively. At 135 ml min(-1), these increased to 136, 89, and 42 mm Hg. Transendoscopic pressure measurements were always within 1 mm Hg of the ventricular pressure. Conclusions. During endoscopy, measurements at the rinsing inlet overestimated the ventricular pressure by similar to 50 mm Hg during heavy rinsing, whereas measurements at the rinsing outlet underestimated the pressure by similar to 50 mm Hg. An electronic tip sensor or a pressure capillary tube placed at the distal end of the lumen of the rinsing channel of the endoscope did not interfere with rinsing flow and produced measurements that were equal to ventricular pressures.},
  author       = {Dewaele, Frank and Kalmar, Alain and Van Canneyt, Koen and Vereecke, H and Absalom, A and Caemaert, Jacques and Struys, Michel and Van Roost, Dirk},
  issn         = {0007-0912},
  journal      = {BRITISH JOURNAL OF ANAESTHESIA},
  keywords     = {ENDOSCOPIC 3RD VENTRICULOSTOMY,INTRACRANIAL-PRESSURE,BRAIN ISCHEMIA,brain,HEMODYNAMICS,blood flow,intracranial pressure,monitoring,surgery,endoscopy,neurological},
  language     = {eng},
  number       = {2},
  pages        = {218--224},
  title        = {Pressure monitoring during neuroendoscopy : new insights},
  url          = {http://dx.doi.org/10.1093/bja/aer161},
  volume       = {107},
  year         = {2011},
}

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