A Noninvasive Technique for Cerebral Compliance Monitoring in Neurocritical Care

Background In neurocritical care, studies have shown that adequate intracranial pressure (ICP) control reduces mortality and increases functionality. Unfortunately, the monitoring ICP through an intracranial catheter as the gold standard currently adopted, is invasive technique and often not available for all patients in need of ICP monitoring. Recently, a device has been developed (B4C), able to obtain recordings of cranial dilatation at each heartbeat and disclose ICP pulses waveforms, as the intracranial compliance (IC) status. However, despite promising results reported in animal and small sample studies, the correlation between this new technique with invasive ICP measurement in particular clinical situations was lacking. The present study aimed to evaluate the use of this noninvasive IC monitoring system in a set of neurocritical care patients, correlating its data with invasive ICP monitoring. Methods: Neurocritical patients under ICP monitoring were consecutively included for the evaluation with B4C sensor concomitantly. ICP values, ICP waveforms, B4C IC waveforms, were correlated. Results: We present results of 22 patients. Traumatic brain injury, subarachnoid hemorrhage, and stroke were among the main causes for ICP monitoring. Pearson’s correlation for B4C parameters such as P2/P1 ratio and time-to-peak disclosed moderate correlation with mean ICP values (0.63 and 0.66 respectively). No reports of adverse events were obtained. Conclusion The novel intracranial compliance monitoring technique demonstrated to be safe and correlated with invasive ICP. This discovery may widen the comprehension, coverage and applications of intracranial compliance in critical care.