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• W2016096669 abstract "To the Editor: Monitoring of the intracranial pressure (ICP) is one of the most important methods to monitor a sedated patient in need of neuro-intensive care. Therefore, it is of outmost importance that the ICP measured is as accurate and reliable as possible. We read with great interest the publication by Al-Tamimi et al1 published in the January 2009 issue of Neurosurgery describing the drift of the Codman MicroSensor (CMS). We congratulate the authors for repeating our study published in 2005 in this very same journal. The authors show a relatively small overall drift of 2 mm Hg (median) and a correlation of drift vs time. Most interesting it is stated in the introduction in the publication1 that “the issue of zero drift has not been effectively quantified and assessed during in vivo use of this system.” In our publication2 we reported our clinical knowledge of CMS from 1000 patients and detail information from 128 patients prospectively studied. Thus our single center study enrolled almost 50% more subjects for the detailed study than presented by Al-Tamimi et al. We showed a very low overall drift of 0.9 ± 0.2 mm Hg (mean ± sem). We did not find a statistically significant drift with time and our mean time of monitoring was 173 hours, which is clearly longer than that reported. Interestingly, when the authors excluded the sensors with a drift of 5 mm Hg or more there was no drift vs time.1 We also compared the simultaneously measured ICP with ventriculostomy and the CMS and found a good correlation (r = 0.79; P < .0001). The average ICP measured with the ventriculostomy was 18.3 ± 0.3 mmHg and with the CMS 19.0 ± 0.2 mmHg. A Bland Altman plot showed a good concordance between the methods. We discuss the pitfalls in using pressure sensors and the importance of a careful and strict calibration of the sensors as described by the manufacture. Of further importance is the correct use of the calibration value, which should be checked whenever the system is disconnected and especially when investigating the zero drift. We have noticed 2 CMS with a drift of more than 5 mm Hg and both of them showed in situ mal-readings and mechanical injuries due to handling. We have also showed the accuracy of measuring ICP with the CMS as compared with a lumbar fluid pillar system.3 We lack a thorough discussion about the reasons for such high number of catheters with a drift over 5 mm Hg as presented by Al-Tamimi et al. Interestingly, the authors of the present study referee to the Guidelines for the management of severe traumatic brain injury,4 which was not published in Neurotrauma but in J Neurotrauma. In that publication our original publication is referred to and it is clear from Table II that we had included 128 patients. We reported 3 minor hematomas in 1000 patients (0.3%) not needing any neurosurgical intervention. Unfortunately, the authors of this part of the Guidelines stated in Table I that we reported 3 hematomas in 28, and in the text that 11% showed hematomas due to insertion of the CMS which is a serious miscalculation. These figures and results have never have been published by us. Just by using the word “Codman” in the PubMed search will immediately find our publication from 2005. This once again shows the importance of reading original papers and not only secondary information. Lars-Owe D. Koskinen Magnus Olivecrona Umeå, Sweden" @default.
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• W2016096669 date "2010-07-01" @default.
• W2016096669 modified "2023-09-26" @default.
• W2016096669 title "Intracranial Pressure Monitoring Using the Codman MicroSensor" @default.
• W2016096669 cites W1976289966 @default.
• W2016096669 cites W2014507834 @default.
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• W2016096669 doi "https://doi.org/10.1227/01.neu.0000371142.74277.b9" @default.
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