• Title/Summary/Keyword: ICP Monitoring

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Current Status of Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury in Korea : A Post Hoc Analysis of Korea Neurotrauma Databank Project with a Nationwide Survey

  • Youngheon Lee;Jung Hwan Lee;Hyuk Jin Choi;Byung Chul Kim;Seunghan Yu;Mahnjeong Ha;The KNTDB Investigators
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.543-551
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    • 2023
  • Objective : This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods : This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results : Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion : The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.

Significance of Intracranial Pressure Monitoring after Early Decompressive Craniectomy in Patients with Severe Traumatic Brain Injury

  • Kim, Deok-Ryeong;Yang, Seung-Ho;Sung, Jae-Hoon;Lee, Sang-Won;Son, Byung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.26-31
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    • 2014
  • Objective : Early decompressive craniectomy (DC) has been used as the first stage treatment to prevent secondary injuries in cases of severe traumatic brain injury (TBI). Postoperative management is the major factor that influences outcome. The aim of this study is to investigate the effect of postoperative management, using intracranial pressure (ICP) monitoring and including consecutive DC on the other side, on the two-week mortality in severe TBI patients treated with early DC. Methods : Seventy-eight patients with severe TBI [Glasgow Coma Scale (GCS) score <9] underwent early DC were retrospectively investigated. Among 78 patients with early DC, 53 patients were managed by conventional medical treatments and the other, 25 patients were treated under the guidance of ICP monitoring, placed during early DC. In the ICP monitoring group, consecutive DC on the other side were performed on 11 patients due to a high ICP of greater than 30 mm Hg and failure to respond to any other medical treatments. Results : The two-week mortality rate was significantly different between two groups [50.9% (27 patients) and 24% (6 patients), respectively, p=0.025]. After adjusting for confounding factors, including sex, low GCS score, and pupillary abnormalities, ICP monitoring was associated with a 78% lower likelihood of 2-week mortality (p=0.021). Conclusion : ICP monitoring in conjunction with postoperative treatment, after early DC, is associated with a significantly reduced risk of death.

Significance of Intracranial Pressure Monitoring in Early Surgery for Poor-Grade Aneurysm Patients (중증 뇌동맥류 환자의 조기 수술에 있어서 뇌압 측정의 중요성)

  • Kim, Sang Su;Kim, Jong Moon;Kang, Sung Don
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.425-429
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    • 2001
  • Objective : Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. Patients and Methods : A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months. Results : In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001). Conclusion : It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.

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A Diagnostic Study of Pulsed Plasma Process for Reactive Deposition (반응성 증착용 펄스 플라즈마 공정의 진단)

  • Joo, Jung-Hoon
    • Journal of the Korean institute of surface engineering
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    • v.45 no.4
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    • pp.168-173
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    • 2012
  • A real-time monitoring of an immersed antenna type inductively coupled plasma (ICP) was done with optical emission spectroscopy (OES) to check the reports that sputtered atom density is decreasing as the ICP power is increased. At 10 mTorr pressure of Ar, Mg was sputtered by a bipolar pulsed power supply into 2 MHz ICP which has an insulator covered 2.5 turn antenna. Emitted light was collected in two different positions: above the target and inside the ICP region. With 100 W of Mg sputtering power, the intensities of Mg I (285.06 nm), Mg II (279.48 nm), Ar I (420.1 nm) were increased constantly with ICP power from 100 W to 600 W. At 500 W, the intensity of $Mg^+$ exceeded that of Mg under PID controlled discharge voltage of 180 V. The ratio of Mg II/Mg I was increased from 0.45 to 2.71 approximately 6 times.

The Effects of Microwave Irradiated on Rabbit's ICP (전자기파 조사가 실험동물의 뇌압에 미치는 영향)

  • Park, Jin-Han;Kim, Seong-Ho;Han, Dong-Ro;Bae, Jang-Ho;Kim, Oh-Lyong;Choi, Byung-Yearn;Cho, Soo-Ho;Lee, Jun-Ha
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.213-220
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    • 1994
  • Damages on central nervous system induced by the exposure of microwave. However, the effects of microwave on ICP are not studied yet. The ICP affected by the condition of the brain has an significant effect on vital sign. So we investigated the changes of ICP of the rabbits after exposure. Twenty four rabbits were devided into 3 groups depending on the amount of exposure to microwave. One group was composed with 8 rabbits were exposed to microwave for 10 miniutes. Other were composed to microwave for 20 miniutes, 30 miniures, respectively. Intracranial pressure on each group were measured by subdural type ICP monitoring catheter immediately, first day, 3rd day, 5th day and 7th day after exposure of microwave. Results indicates that intracranial pressure of rabbits are not affected with statistical significance by exposure of microwave.

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A Correlational Study between Auditory Evoked Potential and Subdural Hematoma for the Diveloprnent of a Noninvasive ICP Monitoring System (비침습적 뇌내압 측정 시스템의 개발을 위한 청각유발전위와 경막혈종간의 상관관계 분석에 관한 연구)

  • ;C.S. Lessard
    • Journal of Biomedical Engineering Research
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    • v.16 no.2
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    • pp.167-174
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    • 1995
  • Development of a noninvasive intensive care system calls for the use of evoked potentials (EPs) as a means of diagnosing traumatic head-injured patients. The experiment entails surgically placing two subarachnoid bolts and a subdural balloon through the skull to simulate a subdural hematoma. Using various levels of intracranial pressure (ICP) and/or different sizes of balloons, auditory evoked potentials (AEPs) were recorded from a rabbit. Six positive peak latencies ($P_1 - P_6$) and five negative peak latencies ($N_l- N_5$) were extracted from an averaged AEP waveform. Multiple regression analyses were performed for determining. a relationship between the ICP and AEP peak latencies. The results indicate that a major correlation of ch, mges on AEP peak latencies is due to mechanical forces of a mass (inflated balloon simulating a hematoma) in the distortion of the brain matter rather than increased ICP itself.

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Monitoring of Heavy Metal Contents in Commercial Herbal Medicines in Korea: Cultivated Herbal Medicines in the Seoul and Daegu Areas (국내 유통 한약재의 중금속 함량 모니터링 -서울과 대구지역 한약재 중심으로 -)

  • Jang, Seol;Lee, Ah-Reum;Lee, A-Eong;Choi, Go-Ya;Kim, Ho-Kyoung
    • Journal of Environmental Health Sciences
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    • v.41 no.1
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    • pp.30-39
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    • 2015
  • Objectives: This study was conducted to determine the heavy metal contents in commercial herbal medicines in Korea. Methods: Monitoring of lead, arsenic, cadmium and mercury was carried out on 116 samples of eleven types of herbal medicines. Among the total samples, 71 samples were domestic and 45 were imported. The samples were digested using the microwave method. The heavy metal contents were measured by inductively coupled plasma atomic emission spectrometry (ICP-AES) and a mercury analyzer. ICP-AES was used to analyze lead, arsenic cadmium. Mercury was analyzed by the amalgamation method. Results: The mean values of the heavy metal contents in the herbal medicines were Pb 0.64mg/kg, As 0.26mg/kg, Cd 0.07mg/kg and Hg 0.004mg/kg. Of the total samples, one violated the MFDS (Ministry of Food and Drug Safety) regulatory guidance on heavy metals in herbal medicines. Lead was detected at more than 5mg/kg in one sample. The measured values of arsenic, cadmium and mercury in the herbal medicines showed levels lower than the recommended levels for herbal medicines in MFDS regulatory guidance. In the comparison of domestic samples with imported herbal medicines, it was found that one domestic sample surpassed the maximum residue limits for lead. Conclusion: These results will be used to establish the regulation and control of heavy metal contents in herbal medicines. In addition, continuous monitoring is needed to ensure confidence in and the safety of these herbal medicines.

Relationship between Increased Intracranial Pressure and Mastoid Effusion

  • Jung, Hoonkyo;Jang, Kyoung Min;Ko, Myeong Jin;Choi, Hyun Ho;Nam, Taek Kyun;Kwon, Jeong-Taik;Park, Yong-sook
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.640-648
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    • 2020
  • Objective : This study aimed to assess the relationship between increased intracranial pressure (ICP) and mastoid effusions (ME). Methods : Between January 2015 and October 2018, patients who underwent intracranial surgery and had ICP monitoring catheters placed were enrolled. ICP was recorded hourly for at least 3 days. ME was determined by the emergence of opacification in mastoid air cells on follow-up brain imaging. C-reactive protein (CRP) levels, presence of endotracheal tube (ETT) and nasogastric tube (NGT), duration of intensive care unit (ICU) stay, duration of mechanical ventilator application, diagnosis, surgical modalities, and presence of sinusitis were recorded. Each factor's effect on the occurrence of ME was analyzed by binary logistic regression analyses. To analyze the independent effects of ICP as a predictor of ME a multivariable logistic regression analysis was performed. Results : Total of 61 (53%) out of 115 patients had ME. Among the patients who had unilateral brain lesions, 94% of subject (43/50) revealed the ipsilateral development of ME. ME developed at a mean of 11.1±6.2 days. The variables including mean ICP, peak ICP, age, trauma, CRP, ICU stays, application of mechanical ventilators and presence of ETT and NGT showed statistically significant difference between ME groups and non-ME groups in univariate analysis. Sex and the occurrence of sinusitis did not differ between two groups. Adding the ICP variables significantly improved the prediction of ME in multivariable logistic regression analysis. Conclusion : While multiple factors affect ME, this study demonstrates that ICP and ME are probably related. Further studies are needed to determine the mechanistic relationship between ICP and middle ear pressure.

Monitoring of Heavy Metal Contents in Commercial Herbal Medicines (유통 한약재의 중금속 잔류실태 조사)

  • Jang, Seol;Kim, Tae Hee;Lee, Ah Reum;Lee, A Yeong;Choi, Goya;Kim, Ho Kyoung
    • Korean Journal of Medicinal Crop Science
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    • v.20 no.6
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    • pp.434-439
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    • 2012
  • This study was conducted to determine the contents of heavy metal in commercial herbal medicines. The monitoring of lead, arsenic, cadmium and mercury was carried out on 100 samples with 10 kinds of herbal medicines. The contents of heavy metal were measured by inductively coupled plasma atomic emission spectrometry (ICP-AES) and mercury analyzer. The mean values of heavy metal contents for herbal medicines were Pb 1.87 mg/kg, As 0.39 mg/kg, Cd 0.26 mg/kg and Hg 0.021 mg/kg. Of the total samples, 19 samples (19%, 4 types) were violated the KFDA regulatory guidance of heavy metal in herbal medicines (9 samples on Pb, 10 samples on Cd). Among these 19 unsuitable samples, 16 samples were domestic and 3 samples were imported. Therefore, we need continuously monitoring to ensure confidence and safety for these herbal medicines.

Temperature Monitoring of Silicon Wafei Surface Exposed to Plasma Discharge

  • Im, Yeong-Dae;Lee, Seung-Hwan;Yu, Won-Jong
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2009.05a
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    • pp.246-246
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    • 2009
  • 유도결합형 플라즈마(ICP) 식각장비 챔버 내부에서 플라즈마에서 노출된 실리콘 웨이퍼의 표면 온도변화를 측정하였다. 플라즈마를 방전할 때 식각 공정변수, 예를 들어 Bias power, ICP power 증가에 따른 실리콘 웨이퍼 표면 온도가 증가하는 현상을 관찰할 수 있었으며 이를 바탕으로 식각되는 실리콘의 표면온도와 플라즈마 내 입자거동 간의 관계를 조사하였다.

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