59579 New Innovation in the Management of Pediatric Hydrocephalus via a Novel Long Term ICP Pressure Sensor

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INTRODUCTION: It is well recognized that the management of hydrocephalus is difficult with evidence suggesting that 2/3 of the presentations to hospital with suspected shunt failure are deemed false alarms. The unmet clinical need is to provide data on ICP to guide clinical decisions. METHODS: 6 pediatric patients with a history of multiple shunt revisions received the Kitea ICP sensor at the time of shunt revision. The additional surgery time for this step averaged 6 min. The sensor is a discrete pressure sensor weighing 0.28 g in is injected directly into the cortex. The sensor wirelessly reports the ICP waveform sampled at 50 Hz and displays the mean ICP to patients. In does not measure ICP continuously but when powered via an external wand. Before discharge patients and families received training on making an ICP measurement. Subsequently they were asked to make regular measurements at home and record symptoms. RESULTS: After 3 months of regular measurements families reported a significant reduction in anxiety surrounding their condition and increased confidence that in the event of shunt failure it would be “easier to convince” hospital staff of the need for clinical investigation. In addition, a significant correlation was found between symptoms (mostly headache) and the mean ICP and the amplitude of the ICP cardiac related waveform. Where a shunt failed there was an abnormally high ICP (+15 mmHg) which returned to normal post revision. CONCLUSIONS: In is concluded that monitoring of ICP via a telemetry offers promise to alter the traditional care pathway by providing actionable ICP information remotely.

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