title: Placement of intracranial pressure monitors by neurointensivists: case series and a systematic review.
abstract: OBJECTIVE
  Placement of an intracranial pressure (ICP) monitor to guide the management of patients with severe traumatic brain injury (TBI) has been historically performed by neurosurgeons. It is hypothesized that ICP monitors can be placed by non-surgeon neurointensivists, with placement success and complication rates comparable to neurosurgeons.
  
  
  METHODS
  Retrospective review and systematic review of the literature.
  
  
  METHODS
  This study reviewed the medical records of patients with TBI who required insertion of parenchymal ICP monitors performed by four neurointensivists in a large level I trauma centre. Patient data recorded were age, gender, CT findings, ICP monitor placement, location and length of placement, complications related to the ICP monitor and patient outcomes.
  
  
  RESULTS
  Thirty-eight (38) monitors (Camino) were placed. Patients' average age was 43.0 years (SD = 21.6); 76% were males. The location of monitor was right frontal in 89% and left frontal in 11%. Mean ICP was 24 (SD = 15), duration of ICP monitor was 4.9 days (SD = 3.6). All monitors were placed successfully. There were no major technical complications, no episodes of major catheter-induced intracranial haemorrhage and no infectious complications. These findings were comparable to published outcomes from neurosurgeon placements.
  
  
  CONCLUSIONS
  It is believed that insertion of ICP monitors by neurointensivists is safe and may aid in providing prompt monitoring of patients with severe TBI.
authors.affiliation: Mercy Hospital St Louis, St Louis University, St Lousi, MO, USA. farid.sadaka@mercy.net
authors.forename: Farid
authors.initials: F
authors.lastname: Sadaka
authors.forename: Jan
authors.initials: J
authors.lastname: Kasal
authors.forename: Rekha
authors.initials: R
authors.lastname: Lakshmanan
authors.forename: Ashok
authors.initials: A
authors.lastname: Palagiri
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000503:physiopathology*; D002983:Clinical Competence / Q000706:statistics & numerical data; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D014193:Trauma Centers; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology