DEVICE TO MEASURE INTRACRANIAL PRESSURE

FIBER OPTIC INTRA CRANIAL CATHETER

FIBER OPTIC INTRACRANIAL CATHETER

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This device used for measure ICP

Intracranial pressure (ICP), the pressure inside the cranium, is the result of 

blood, tissue, and cerebrospinal fluid circulating in the ventricles and subarachnoid space. 

ICP monitoring is used to assess Cerebral perfusion. When ICP increases, as a result of conditions such as a mass (e.g., a tumor), bleeding into the brain or fluid around the brain,or swelling within the brain matter itself, neurologic consequences may range from minor to severe, including death.

            Normal ICP= 5-15mmHg

            Mild= 16-20mmHg

            Moderate= 21-30mmHg

            Severe= >30mmHg

Fiber optic catheters directly monitor ICP using an intracranial transducer located in the tip of the catheter. A miniature transducer in the catheter tip is coupled by a long, continuous wire or fiber optic 

cable to an external electronic module. 

This device can be inserted into the lateral ventricle, subarachnoid space, subdural space, brain parenchyma, or under a bone flap. The dura is perforated, and the transducer probe is threaded through the cerebral tissue to the desired depth and 

fixed in position. These devices are not fluid-filled systems, eliminating the problems associated with an external transducer and pressure tubing, such as an external ventriculostomy.

The monitor provides continuous information. Fiber optic catheters can be used to monitor the ICP and cerebral perfusion pressure (CPP). Some versions of catheters can also be used to drain cerebral spinal fluid (CSF). These devices are calibrated by the manufacturer and 

zero-balanced only once at the time of insertion.

[CPP= Cerebral Perfusion Pressure]

[MAP= Mean Arterial Pressure]

CPP= MAP-ICP

Normal CPP= 70-100mmhg

NURSING DIAGNOSIS

• Risk for Infection

• Risk for Ineffective Cerebral Tissue      Perfusion

• Risk for Injury

• Pain

PLANNING

• Patient maintains intracranial pressure at less than 15 mm Hg and cerebral perfusion pressure at 60 to 90 mm Hg.

• Patient is free from infection.

• Patient is free from pain.

• Patient and significant others understand the need for the ventriculostomy.

IMPLEMENTATION

1. Review the medical orders for specific information about monitoring parameters.

2. Perform hand hygiene.

3. Identify the patient.

4. Provide privacy to patient.

5. Explain Procedure to the patient.

6. Assess the patient for any changes in neurologic status.

7. Assess ICP, MAP, and CPP at least hourly. Note ICP value and waveforms as shown on the monitor.

 If there is an increase in the ICP, the value 

should be obtained more often, as often as every 15 minutes. 

Note drainage amount, color, clarity.

8. Care for the insertion site maintain the system using strict sterile technique.

Assess the site for any signs of infection, such as drainage, redness, or warmth. 

Ensure the catheter is secured.

9. Calculate the CPP, if necessary. Calculate the difference between the systemic MAP 

and the ICP.

(Note:- CPP is an estimate of the adequacy of the blood supply to the brain.)

10. Perform hand hygiene.

EVALUATION

• Patient demonstrates a CPP and an ICP within identified parameters.

• Patient remains free from infection.

• Patient understands the need for the catheter and monitoring.

• Patient reports no pain.

DOCUMENTATION

• Document the following information: 

Neurologic assessment; ICP and CPP; vital signs; pain; appearance of insertion site.