Identifying Unmet Clinical Needs

WHAT IS ICP?

• The cranium is a rigid structure that contains 3 main components: brain, cerebrospinal fluid, and blood. Any increase in the volume of its contents will increase the pressure within the cranial vault. An increase in the volume of one component will result in a decrease in volume in one or two of the other components.

• The clinical implication of the change in volume of the component is a decrease in cerebral blood flow or herniation of the brain.

• The pressure in the cranial vault is measured in millimeters of mercury (mm Hg) and is normally less than 20 mm Hg.

INDICATIONS FOR ICP MONITORING

According to the American Brain Trauma Foundation, ICP monitoring is indicated in all cases of traumatic brain injury with a Glasgow Coma Scale score (GCS) between 3–8 and an abnormal CT scan, that is, one showing hematomas, contusion, swelling, herniation, or compressed basal cisterns.

Also used for Intracerebral hemorrhage, Subarachnoid Hemorrhage, Hydrocephalus, Malignant Infarction, Cerebral Edema, CNS infections, and Hepatic Encephalopathy.

Intracranial pressure monitoring (ICP) involves measuring the pressure in the skull by placing a small probe inside the skull, which is attached to the other end to a bedside monitor.

PROBLEMS FACED CURRENTLY

1. Catheter-related infections are in the range of 0-27% 2. Post-operative hemorrhage - with significant intracranial hemorrhage = 10.6% 3. Incorrect placement of catheter identified retrospectively = 12.4%.

Can result in reoperation, leading to higher infection rates and/or damage to important cerebral

structures.