Cargando…

A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world

BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters hav...

Descripción completa

Detalles Bibliográficos
Autores principales: Gupta, Deepak Kumar, Bisht, Ajay, Batra, Priyam, Mathur, Purva, Mahapatra, Ashok Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974969/
https://www.ncbi.nlm.nih.gov/pubmed/27695548
http://dx.doi.org/10.4103/1793-5482.165785
_version_ 1782446638839627776
author Gupta, Deepak Kumar
Bisht, Ajay
Batra, Priyam
Mathur, Purva
Mahapatra, Ashok Kumar
author_facet Gupta, Deepak Kumar
Bisht, Ajay
Batra, Priyam
Mathur, Purva
Mahapatra, Ashok Kumar
author_sort Gupta, Deepak Kumar
collection PubMed
description BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations. HYPOTHESIS: Resterilized intra-parenchymal strain gauge catheters can be used safely for ICP monitoring without any added risk of meningitis. The reusage of catheters can bring down the costs. Resterilized catheters/equipment have been approved for usage in cardiac usage, but such study on ICP catheters has not been carried out so far in any part of the world. METHODOLOGY: A total of 100 consecutive cases of severe TBI receiving ICP monitoring at a level 1 trauma center of a developing nation were prospectively studied (34 cases had fresh catheters, and 66 had resterilized [using ethylene oxide] catheters). OBSERVATIONS: The use of reused resterilized catheters was not associated with increased incidence of meningitis or fever (the surrogate marker for infection in this study). Also, there was concordance between the pressure recording of reused catheters and operative finding/subsequent computed tomography scans. These catheters after sterilization could be reused 2–4 times and reliably recorded the ICP (insignificant drift) with no increase in the incidence of meningitis. CONCLUSIONS: Usage of resterilized intra-parenchymal ICP catheters is feasible, safe, efficacious, and cost effective and brings down the cost of monitoring significantly.
format Online
Article
Text
id pubmed-4974969
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-49749692016-10-01 A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world Gupta, Deepak Kumar Bisht, Ajay Batra, Priyam Mathur, Purva Mahapatra, Ashok Kumar Asian J Neurosurg Original Article BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations. HYPOTHESIS: Resterilized intra-parenchymal strain gauge catheters can be used safely for ICP monitoring without any added risk of meningitis. The reusage of catheters can bring down the costs. Resterilized catheters/equipment have been approved for usage in cardiac usage, but such study on ICP catheters has not been carried out so far in any part of the world. METHODOLOGY: A total of 100 consecutive cases of severe TBI receiving ICP monitoring at a level 1 trauma center of a developing nation were prospectively studied (34 cases had fresh catheters, and 66 had resterilized [using ethylene oxide] catheters). OBSERVATIONS: The use of reused resterilized catheters was not associated with increased incidence of meningitis or fever (the surrogate marker for infection in this study). Also, there was concordance between the pressure recording of reused catheters and operative finding/subsequent computed tomography scans. These catheters after sterilization could be reused 2–4 times and reliably recorded the ICP (insignificant drift) with no increase in the incidence of meningitis. CONCLUSIONS: Usage of resterilized intra-parenchymal ICP catheters is feasible, safe, efficacious, and cost effective and brings down the cost of monitoring significantly. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4974969/ /pubmed/27695548 http://dx.doi.org/10.4103/1793-5482.165785 Text en Copyright: © Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Gupta, Deepak Kumar
Bisht, Ajay
Batra, Priyam
Mathur, Purva
Mahapatra, Ashok Kumar
A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title_full A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title_fullStr A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title_full_unstemmed A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title_short A cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
title_sort cost effectiveness based safety and efficacy study of resterilized intra-parenchymal catheter based intracranial pressure monitoring in developing world
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974969/
https://www.ncbi.nlm.nih.gov/pubmed/27695548
http://dx.doi.org/10.4103/1793-5482.165785
work_keys_str_mv AT guptadeepakkumar acosteffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT bishtajay acosteffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT batrapriyam acosteffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT mathurpurva acosteffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT mahapatraashokkumar acosteffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT guptadeepakkumar costeffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT bishtajay costeffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT batrapriyam costeffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT mathurpurva costeffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld
AT mahapatraashokkumar costeffectivenessbasedsafetyandefficacystudyofresterilizedintraparenchymalcatheterbasedintracranialpressuremonitoringindevelopingworld