Use of fiber-optic pressure transducer for intracranial pressure measurements: a preliminary report.

Invasive monitoring of intracranial pressure (ICP) is becoming the standard of care for management of acute neurologic and neurosurgical patients. As a result of improved fiber-optic technology, a new disposable 4 French fiber-optic transducer-tipped catheter (FTC) has been introduced for facilitating measurement of intracranial pressure. Placement of the FTC can be intraventricular, subarachnoid, subdural, or intraparenchymal. Sensitivity and linearity of each catheter are manufacturer calibrated and not adjustable. Zero or atmospheric balance is done only once before insertion. Because the transducer is the catheter tip, no leveling to an anatomic point is necessary. The system appears to eliminate some of the difficulties inherent in fluid-filled catheter monitoring. In clinical trials, the comparison of FTC with subdural and ventriculostomy waveforms and pressures showed essentially no difference. Pressure recordings tracked well except during transient periods of increased ICP, when FTC showed higher peak pressures. Use of the FTC requires education regarding placement and maintenance techniques. Although staff experience with the catheter can practically eliminate the problem, the FTC catheters need special handling because of potential for fiber breakage.