Noninvasive intracranial compliance monitoring - Technical note and clinical results
Noninvasive intracranial compliance monitoring - Technical note and clinical results
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DOI：
10.3171/jns.2003.98.1.0214
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发表时间：
2003-01-01
影响因子：
4.1
通讯作者：
Mehdorn, HM
中科院分区：
文献类型：
--
作者：
Lang, EW;Paulat, K;Mehdorn, HM
虽然侵入性测量颅内压（ICP）包括高分辨率波形分析可以评估颅内顺应性（ICC），但它仅在少数选定的神经外科条件下可行。颅内依从性可以使用高频质心（HFC）来评估，这是ICP波形4至15 hz波段内的功率加权平均频率。作者系统地测试了一种无创性ICC监测仪的实用性、性能和可靠性。该装置的基本原理是ICP传输及其次声波通过内耳向鼓膜传输。如果外耳被密封，鼓膜的运动引起气压波动，可以用特殊的传感器记录下来。作者比较了由肺内ICP传感器计算的HFC与同时从同侧放置的无创设备在半个呼吸周期（峰值到基线）以及三个心脏周期的随机样本中获得的HFC。他们分析了13例已建立机械通气的患者的32个疗程。在36次会议中，有4次（11%）他们不能表现出足够的信号。从峰值到基线周期，有创记录的平均HFC为8.05 +/- 0.55 Hz（范围6.7-9 Hz），而无创记录的平均HFC为8.04 +/- 0.49 Hz（范围7-9.3 Hz）。ICP为8.5 +/- 5mmhg（范围2- 24mmhg）。对于随机抽样的三个心脏周期，数值分别为7.73 +/- 0.51 Hz（范围6.7-8.6 Hz）和7.76 +/- 0.56 mm Hg（范围6.5-8.8 mm Hg）。该设备允许基于HFC波形分析对ICC进行无创评估，其结果与有创肺内记录获得的结果相同。监测装置可能成为一个有价值的监测参数的工具，在病人的位置颅内传感器是不可行的，但评估ICC作为ICP测量的替代方案是必要的。
Although invasive measurement of intracranial pressure (ICP) involving high-resolution waveform analysis allows assessment of intracranial compliance (ICC), it is only feasible in a few selected neurosurgical conditions. Intracranial compliance can be assessed using the high-frequency centroid (HFC), which is the power-weighted mean frequency within the 4 to 15-Hz band of the ICP waveform. The authors have systematically tested the utility, performance, and reliability of a noninvasive monitor of ICC. The underlying principle of this device is that the ICP transmission and its infrasonic waves are transmitted through the inner ear toward the tympanic membrane. If the outer ear is sealed in an airtight fashion, motions of the tympanic membrane cause air pressure fluctuations that can be recorded using a special sensor.The authors compared the HFC calculated from an intraparenchymal ICP sensor with that obtained simultaneously from an ipsilaterally placed noninvasive device during half of a respiratory cycle (peak to baseline) as well as for three random samples of three heart cycles. They analyzed 32 sessions in 13 patients in whom mechanical ventilation had been established. In four (11%) of 36 sessions they could not demonstrate an adequate signal.For the peak-to-baseline cycle, the mean invasively recorded HFC was 8.05 +/- 0.55 Hz (range 6.7-9 Hz) whereas the mean noninvasively recorded HFC was 8.04 +/- 0.49 Hz (range 7-9.3 Hz). The ICP was 8.5 +/- 5 mm Hg (range 2-24 mm Hg). For the three heart cycles randomly sampled, the values were 7.73 +/- 0.51 Hz (range 6.7-8.6 Hz) and 7.76 +/- 0.56 mm Hg (range 6.5-8.8 mm Hg), respectively.This device allows noninvasive assessment of ICC based on the HFC waveform analysis that is equivalent to that obtained by invasive intraparenchymal recording. The monitoring device may become a valuable tool for monitoring parameters in patients in whom placement of an intracranial sensor is not feasible but assessment of ICC as an alternative to ICP measurement is desired.