Development of a Clinical Monitoring System by Means of ICP Waveform Analysis
Recording the mean intracranial pressure (ICP) as an index of potential herniation has been the standard for intracranial monitoring. The mean intracranial pressure represents only one parameter of a complex control system. The mean ICP may not show variations until late in the course of a pathologic process or may never be elevated despite progressive injury to the brain. Intracranial compliance has been proposed to have a greater prognostic value than the mean ICP (Sullivan et al., 1980). The pressure volume index (PVI) is at present the most useful test for determination of intracranial compliance (Shapiro et al., 1980). The PVI is not suitable for continuous monitoring, since it requires volumetric manipulation of the cerebrospinal fluid (CSF). Similarly, currently used techniques for measurement of cerebral blood flow (CBF) are not suited to continuous monitoring (Langfitt, 1975).
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