• Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. Intracranial pressure monitoring technology. J Neurotrauma 2007;24(Suppl 1):S45-S54. [41 references]

This is the current release of the guideline.

This guideline updates previous versions: Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, Joint Section on Neurotrauma and Critical Care. Guidelines for the management of severe traumatic brain injury: cerebral perfusion pressure. New York (NY): Brain Trauma Foundation, Inc.; 2003 Mar 14. 14 p.

Brain Trauma Foundation, Inc, American Association of Neurological Surgeons. Part 1: guidelines for the management of severe traumatic brain injury. New York (NY): Brain Trauma Foundation, Inc.; 2000. 165 p.

Conclusions

In the current state of technology, the ventricular catheter connected to an external strain gauge is the most accurate, low-cost, and reliable method of monitoring intracranial pressure (ICP). It also can be recalibrated in situ. ICP transduction via fiberoptic or micro strain gauge devices placed in ventricular catheters provide similar benefits, but at a higher cost.

Parenchymal ICP monitors cannot be recalibrated during monitoring. Parenchymal ICP monitors, using micro strain pressure transducers, have negligible drift. The measurement drift is independent of the duration of monitoring.

Subarachnoid, subdural, and epidural monitors (fluid coupled or pneumatic) are less accurate.

Summary

In patients who receive ICP monitoring, a ventricular catheter connected to an external strain gauge transducer is the most accurate and cost effective method of monitoring ICP. Clinically significant infections or hemorrhage associated with ICP devices causing patient morbidity are rare and should not deter the decision to monitor ICP.

Parenchymal transducer devices measure ICP similar to ventricular ICP pressure but have the potential for measurement differences due to the inability to recalibrate. These devices are advantageous when ventricular ICP is not obtained or if there is obstruction in the fluid couple. Subarachnoid or subdural fluid coupled devices and epidural ICP devices are currently less accurate.

None provided

The type of supporting evidence is not specifically stated for each conclusion.

• Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. Intracranial pressure monitoring technology. J Neurotrauma 2007;24(Suppl 1):S45-S54. [41 references]

Not applicable: The guideline was not adapted from another source.

2000 (revised 2007)

Brain Trauma Foundation - Disease Specific Society

Brain Trauma Foundation

Not stated

Primary Authors: Susan Carson, MPH, Oregon Health & Science University; Cynthia Davis-O'Reilly, BSc, Brain Trauma Foundation Center for Guidelines Management; Pamela Drexel, Brain Trauma Foundation; Rochelle Fu, PhD, Oregon Health & Science University; Susan Norris, MD, MPH, MSc, Oregon Evidence-based Practice Center; Michelle Pappas, BA, Brain Trauma Foundation Center for Guidelines Management; Kimberly Peterson, MS, Oregon Health & Science University; Adair Prall, MD, South Denver Neurosurgery; Patricia Raksin, MD, Cook County Hospital

Not stated

Congress of Neurological Surgeons - Professional Association

This is the current release of the guideline.

This guideline updates previous versions: Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, Joint Section on Neurotrauma and Critical Care. Guidelines for the management of severe traumatic brain injury: cerebral perfusion pressure. New York (NY): Brain Trauma Foundation, Inc.; 2003 Mar 14. 14 p.

Brain Trauma Foundation, Inc, American Association of Neurological Surgeons. Part 1: guidelines for the management of severe traumatic brain injury. New York (NY): Brain Trauma Foundation, Inc.; 2000. 165 p.

None available

None available

This NGC summary was completed by ECRI Institute on August 14, 2007. The information was verified by the guideline developer on January 28, 2008.

This is a limited license granted to NGC, AHRQ and its agent only. It may not be assigned, sold, or otherwise transferred. BTF owns the copyright. For any other permission regarding the use of these guidelines, please contact the Brain Trauma Foundation.