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    "titulo" => "Experiencia cl&#237;nica con la monitorizaci&#243;n de la presi&#243;n intracraneal&#46; Estudio retrospectivo de 239 pacientes monitorizados con el Sistema Camino<span class="elsevierStyleSup">&#174;</span>"
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La monitorizaci&#243;n invasiva de la presi&#243;n intracraneal &#40;PIC&#41; se ha convertido en el estandar en el manejo y cuidado de pacientes neurol&#243;gicos agudos y neuroquir&#250;rgicos susceptibles de padecer hipertensi&#243;n intracraneal&#46;</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Describir el tipo de patolog&#237;a que motiv&#243; la monitorizaci&#243;n&#44; terap&#233;uticas derivadas de &#233;sta&#44; as&#237; como las complicaciones m&#225;s frecuentes entre los pacientes monitorizados con el sistema Camino<span class="elsevierStyleSup">&#174;</span>&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio retrospectivo de todos los pacientes sometidos a monitorizaci&#243;n de la presi&#243;n intracraneal con sensores de fibra &#243;ptica Camino <span class="elsevierStyleSup">&#174;</span>&#44; en sus tres modalidades&#44; en el per&#237;odo de tiempo comprendido entre 1992&#8211;1995&#44; ambos incluidos&#46; Se colocaron 239 sensores de presi&#243;n intracraneal &#40;120 intraparenquimatosos&#44; 93 subdurales&#44; 26 intraventriculares&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La duraci&#243;n media de la monitorizaci&#243;n fue de 5&#44;1 d&#237;as&#46; La patolog&#237;a m&#225;s frecuente fue el traumatismo craneoencef&#225;lico &#40;152 casos&#41; y entre ellos los accidentes de tr&#225;fico &#40;103 casos&#41;&#46; Dentro de las intervenciones terap&#233;uticas derivadas de la monitorizaci&#243;n de la PIC&#44; la m&#225;s frecuente fue el tratamiento m&#233;dico &#40;hiperventilaci&#243;n&#44; sedaci&#243;n&#44; coma barbit&#250;rico&#41;&#46; Las complicaciones m&#225;s frecuentes fueron la hemorragia y la infecci&#243;n&#46; Se observ&#243; sangrado en el 1&#44;6&#37; del total de pacientes&#44; ascendiendo al 11&#37; en pacientes con coagulopat&#237;a&#46; La tasa de infecci&#243;n cl&#237;nicamente manifiesta fue del 1&#44;6&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La monitorizaci&#243;n de la PIC con sensores de fibra &#243;ptica es un m&#233;todo preciso y seguro pero con limitaciones&#46; En aquellos pacientes con coagulopat&#237;a de base se recomienda la monitorizaci&#243;n con otros m&#233;todos menos invasivos &#40;epidurales&#41;&#46; Se ha observado un incremento de la tasa de infecci&#243;n en aquellos monitores implantados m&#225;s de 5 d&#237;as especialmente en los intraventriculares&#44; por lo que en estos casos se recomienda un cambio de sensor si se prevee una monitorizaci&#243;n prolongada&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Intracranial pressure &#40;ICP&#41; monitoring has become the standard in management and care of acute neurosurgical and neurological patients with raised ICP&#46;</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Describing the intracranial pathology leading to ICP monitoring&#44; the therapies applied&#44; and the infection and hemorrhage rates among patients monitored with Camino<span class="elsevierStyleSup">&#174;</span> ICP fiberoptic devices&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A retrospective study was performed&#44; including all the patients monitored with Camino devices in their three modalities&#46; The study lasted from 1992 to 1995&#46; We placed 239 ICP devices &#40;120 intraparenchymal&#44; 93 subdural&#44; and 26 intraventricular&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Mean monitoring time was 5&#44;17 days&#46; Most common cause of monitoring was head injury in 152 cases&#46; Most common therapy because of raised ICP was medical treatment &#40;hyperventilation&#44; sedation and barbituric coma&#41;&#46; Most common related complications were hemorrhage and infection&#46; Hemorrhage rate was 1&#44;6&#37; in the whole group&#44; but among the patient with disorders it increased to 11 &#37;&#46; Infection rate was 1&#44;6&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">ICP monitoring with fiberoptic devices is an accurate and safe method&#44; but it has its own limits&#46; In those patients with coagulation disorders we recomend ICP monitoring with other&#44; less invasive devices&#44; such epidural sensors&#46; We have noticed an increased infection rate in patients monitored for more than 5 days&#44; especially with the intraventricular sensor&#46; We recommend changing the device if the expected period of monitoring is long more than 5 days&#46;</p>"
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Vol. 10. Núm. 4.
Páginas 291-296 (enero 1998)
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Vol. 10. Núm. 4.
Páginas 291-296 (enero 1998)
Experiencia clínica con la monitorización de la presión intracraneal. Estudio retrospectivo de 239 pacientes monitorizados con el Sistema Camino®
Clinical experience of intracranial pressure monitoring. Retrospective study in 239 Camino® monitored patients
Visitas
2707
R.M. Martínez-Mañas, E. Ferrer Rodríguez, C. García-Amorena García
Servicio de Neurocirugía. Hospital Clinic i Provincial de Barcelona. Universitat de Barcelona
Este artículo ha recibido
Información del artículo
Resumen
Introducción

La monitorización invasiva de la presión intracraneal (PIC) se ha convertido en el estandar en el manejo y cuidado de pacientes neurológicos agudos y neuroquirúrgicos susceptibles de padecer hipertensión intracraneal.

Objetivos

Describir el tipo de patología que motivó la monitorización, terapéuticas derivadas de ésta, así como las complicaciones más frecuentes entre los pacientes monitorizados con el sistema Camino®.

Material y métodos

Se realizó un estudio retrospectivo de todos los pacientes sometidos a monitorización de la presión intracraneal con sensores de fibra óptica Camino ®, en sus tres modalidades, en el período de tiempo comprendido entre 1992–1995, ambos incluidos. Se colocaron 239 sensores de presión intracraneal (120 intraparenquimatosos, 93 subdurales, 26 intraventriculares).

Resultados

La duración media de la monitorización fue de 5,1 días. La patología más frecuente fue el traumatismo craneoencefálico (152 casos) y entre ellos los accidentes de tráfico (103 casos). Dentro de las intervenciones terapéuticas derivadas de la monitorización de la PIC, la más frecuente fue el tratamiento médico (hiperventilación, sedación, coma barbitúrico). Las complicaciones más frecuentes fueron la hemorragia y la infección. Se observó sangrado en el 1,6% del total de pacientes, ascendiendo al 11% en pacientes con coagulopatía. La tasa de infección clínicamente manifiesta fue del 1,6%.

Conclusiones

La monitorización de la PIC con sensores de fibra óptica es un método preciso y seguro pero con limitaciones. En aquellos pacientes con coagulopatía de base se recomienda la monitorización con otros métodos menos invasivos (epidurales). Se ha observado un incremento de la tasa de infección en aquellos monitores implantados más de 5 días especialmente en los intraventriculares, por lo que en estos casos se recomienda un cambio de sensor si se prevee una monitorización prolongada.

Palabras clave:
Monitorización
Presión intracraneal
Traumatismo craneoencefálico
Summary
Introduction

Intracranial pressure (ICP) monitoring has become the standard in management and care of acute neurosurgical and neurological patients with raised ICP.

Objectives

Describing the intracranial pathology leading to ICP monitoring, the therapies applied, and the infection and hemorrhage rates among patients monitored with Camino® ICP fiberoptic devices.

Material and methods

A retrospective study was performed, including all the patients monitored with Camino devices in their three modalities. The study lasted from 1992 to 1995. We placed 239 ICP devices (120 intraparenchymal, 93 subdural, and 26 intraventricular).

Results

Mean monitoring time was 5,17 days. Most common cause of monitoring was head injury in 152 cases. Most common therapy because of raised ICP was medical treatment (hyperventilation, sedation and barbituric coma). Most common related complications were hemorrhage and infection. Hemorrhage rate was 1,6% in the whole group, but among the patient with disorders it increased to 11 %. Infection rate was 1,6%.

Conclusions

ICP monitoring with fiberoptic devices is an accurate and safe method, but it has its own limits. In those patients with coagulation disorders we recomend ICP monitoring with other, less invasive devices, such epidural sensors. We have noticed an increased infection rate in patients monitored for more than 5 days, especially with the intraventricular sensor. We recommend changing the device if the expected period of monitoring is long more than 5 days.

Key words:
Fiberoptic devices
Intracranial pressure
Head injury
Monitoring

Artículo

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