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Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility
BACKGROUND: The high cost and non-availability of standard ICP monitoring devices limit their use in low- and middle-income countries like Nigeria. This study aims to demonstrate the use of an improvised intraventricular ICP monitoring device as a feasible alternative. RESEARCH QUESTION: Are improvi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293291/ https://www.ncbi.nlm.nih.gov/pubmed/37383472 http://dx.doi.org/10.1016/j.bas.2023.101737 |
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author | Usuah, John Jesuyajolu, Damilola Bankole, Olufemi Ojo, Omotayo |
author_facet | Usuah, John Jesuyajolu, Damilola Bankole, Olufemi Ojo, Omotayo |
author_sort | Usuah, John |
collection | PubMed |
description | BACKGROUND: The high cost and non-availability of standard ICP monitoring devices limit their use in low- and middle-income countries like Nigeria. This study aims to demonstrate the use of an improvised intraventricular ICP monitoring device as a feasible alternative. RESEARCH QUESTION: Are improvised ICP Monitoring devices feasible and effective in resource-constrained settings? MATERIALS AND METHODS: The study was a prospective single-institution investigation involving 54 adult patients that presented with severe TBI (GCS of 3–8) within 72 h of injury and required operative intervention. All patients underwent craniotomy or primary decompressive craniectomy (DC) to evacuate traumatic mass lesions. 14-day in-hospital mortality was used as a primary endpoint of the study. 25 patients had ICP monitoring postoperatively using the improvised device. RESULTS: The modified ICP device was replicated using a feeding tube and a manometer with 0.9% saline as a coupling agent. Based on hourly ICP recording (up to 72 h), patients were observed as having high ICP (>27 cm H(2)O) and normal ICP (27 cm H(2)O). In the ICP-monitored group, raised ICP was detected more than in the clinically assessed group (84% vs 12% p= <0.001). DISCUSSION AND CONCLUSION: There was a 3-time higher mortality rate among the non-ICP monitored participants (31%) compared to the ICP-monitored participants (12%), although this did not reach statistical significance due to the small sample size. This preliminary study has shown that this modified ICP monitoring system is a relatively feasible alternative for diagnosing and treating elevated ICP in severe TBI in resource-constrained environments. |
format | Online Article Text |
id | pubmed-10293291 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-102932912023-06-28 Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility Usuah, John Jesuyajolu, Damilola Bankole, Olufemi Ojo, Omotayo Brain Spine Article BACKGROUND: The high cost and non-availability of standard ICP monitoring devices limit their use in low- and middle-income countries like Nigeria. This study aims to demonstrate the use of an improvised intraventricular ICP monitoring device as a feasible alternative. RESEARCH QUESTION: Are improvised ICP Monitoring devices feasible and effective in resource-constrained settings? MATERIALS AND METHODS: The study was a prospective single-institution investigation involving 54 adult patients that presented with severe TBI (GCS of 3–8) within 72 h of injury and required operative intervention. All patients underwent craniotomy or primary decompressive craniectomy (DC) to evacuate traumatic mass lesions. 14-day in-hospital mortality was used as a primary endpoint of the study. 25 patients had ICP monitoring postoperatively using the improvised device. RESULTS: The modified ICP device was replicated using a feeding tube and a manometer with 0.9% saline as a coupling agent. Based on hourly ICP recording (up to 72 h), patients were observed as having high ICP (>27 cm H(2)O) and normal ICP (27 cm H(2)O). In the ICP-monitored group, raised ICP was detected more than in the clinically assessed group (84% vs 12% p= <0.001). DISCUSSION AND CONCLUSION: There was a 3-time higher mortality rate among the non-ICP monitored participants (31%) compared to the ICP-monitored participants (12%), although this did not reach statistical significance due to the small sample size. This preliminary study has shown that this modified ICP monitoring system is a relatively feasible alternative for diagnosing and treating elevated ICP in severe TBI in resource-constrained environments. Elsevier 2023-04-05 /pmc/articles/PMC10293291/ /pubmed/37383472 http://dx.doi.org/10.1016/j.bas.2023.101737 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Usuah, John Jesuyajolu, Damilola Bankole, Olufemi Ojo, Omotayo Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title | Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title_full | Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title_fullStr | Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title_full_unstemmed | Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title_short | Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility |
title_sort | improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: a single-centre randomised study demonstrating feasibility |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293291/ https://www.ncbi.nlm.nih.gov/pubmed/37383472 http://dx.doi.org/10.1016/j.bas.2023.101737 |
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