Home telemonitoring of intracranial pressure

Acta Neurochir (Wien). 2019 Aug;161(8):1605-1617. doi: 10.1007/s00701-019-03959-5. Epub 2019 Jun 5.

Abstract

Background: As technical progress advances, telemonitoring has become an important part of patient care in many areas of medical treatment. However, distanced surveillance of intracranial pressure (ICP) could not be established so far. With the recent introduction of a telemetric ICP measurement probe, new possibilities arise. Here, we report on a new home setup enabling home telemonitoring of intracranial pressure.

Methods: Twenty patients suffering from disturbances of cerebrospinal fluid circulation, who underwent insertion of a telemetric ICP measurement probe, were provided with medical equipment to read ICP at home and save the data on an internet-enabled computer. Training in handling the equipment was performed during in-patient stay; recorded and uploaded ICP data was then analyzed online. Therefore, the treating medical team was able to access the ICP data via a secure internet connection while telephone conferencing with the patient.

Results: Almost 7400 h of ICP data were recorded at home and evaluated via an internet connection according to the telemonitoring setup. This corresponds to an average record time of about 370 h per patient. ICP profiles were observed following endoscopic treatment, shunting procedures, or valve adjustments. The mean distance between the patients' residence and the consulting hospital was 172 km (range, 16-649 km).

Conclusions: ICP measurements have become accessible for telemonitoring purposes. This new management of hydrocephalus reflects an alternative method in patient care, especially for those who live far away from specialized centers.

Keywords: Home monitoring; Hydrocephalus; Intracranial pressure; P-tel; Telemetric ICP measurement; Telemonitoring.

MeSH terms

  • Female
  • Humans
  • Hydrocephalus / diagnosis*
  • Hydrocephalus / therapy
  • Intracranial Pressure*
  • Male
  • Middle Aged
  • Monitoring, Ambulatory / instrumentation
  • Monitoring, Ambulatory / methods*
  • Telemetry / instrumentation
  • Telemetry / methods*