Journal article
A Novel External Ventricular Drain Sensor to Improve Acquired Brain Injury Monitoring
MILITARY MEDICINE, v 188, p334
08 Nov 2023
PMID: 37948253
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction The insufficiency of current methods to capture the context and environment of neurocritical care can negatively impact patient outcomes. Insertion of an external ventricular drain (EVD) into the ventricles to monitor intracranial pressure (ICP) is a common lifesaving procedure for acquired brain injury patients. Yet, nursing interventions that significantly affect the measured ICP value, such as changing the EVD stopcock position, are poorly documented. Environmental factors like light and noise levels are not monitored as standard of care despite worse outcomes in patients affiliated with sensory sensitivities. Capturing these missing data is an essential first step toward quantifying their effects. Materials and Methods Our entry point was the development of a stopcock position sensor (SPS) that attaches to the EVD stopcock and time-synchronously annotates the recorded ICP data with its position. A two-phase, prospective, nonrandomized observational study was conducted to evaluate the efficacy of the SPS. Phase I assessed the SPS using an ex vivo simulation of ICP management. Phase II involved human subjects with the SPS attached to the EVD stopcock while patients were managed per standard of care. Results The SPS accurately annotated the ICP data and identified that the EVD drained the cerebrospinal fluid for 94.52% of total patient monitoring time (16.98h). For only 3.54% of the time, the stopcock directed the cerebrospinal fluid into the pressure transducer for accurate ICP measurement. For the remaining 1.94% of the time, the stopcock was positioned off: No cerebrospinal fluid drainage and no ICP monitoring. Conclusions We successfully captured an important aspect of the ICP monitoring context, the EVD stopcock position, and time-synchronized it with the recorded physiology. Our system enables future investigations into the impact that a broad contextual data environment has on physiological measurements and acquired brain injury patient outcomes. In the future, we aim to capture additional contextual data sources and expand the scope to battlefield environments.
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Details
- Title
- A Novel External Ventricular Drain Sensor to Improve Acquired Brain Injury Monitoring
- Publication Details
- MILITARY MEDICINE, v 188, p334
- Publisher
- OXFORD UNIV PRESS; OXFORD
- Grant note
- This work was supported by the Assistant Secretary of Defense for Health Affairs through the Defense Medical Research and Development Program/Joint Program Committee 6/Combat Casualty Care Research Program/Precision Trauma Care Research Award (no. W81XWH-19-2-0013).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:001142773700045
- Scopus ID
- 2-s2.0-85176455500
- Other Identifier
- 991021861198504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology