{"paper_id":"30ce4d34-e678-489a-b781-069fdfc799f4","body_text":"In vivo testing of the Pressio intracranial pressure monitor: the EPIC study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article In vivo testing of the Pressio intracranial pressure monitor: the EPIC study Laurent GERGELE, Jérémy Mallard, Clément Magand, Kevin Lagarde, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5861409/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Jun, 2025 Read the published version in Neurocritical Care → Version 1 posted 5 You are reading this latest preprint version Abstract Objective Measuring reliable intracranial pressure (ICP) is critical for patients with acute brain injuries. The aim of this study was to evaluate zero-drift of the intra-parenchymal strain gauge Pressio transducer (Sophysa, Orsay, France) in clinical conditions. Methods A prospective, observational multicentre study was conducted in 4 French intensive care units (ICU) of university hospitals. Patients with acute brain injuries were included if they needed ICP measurement using the Pressio transducer. The zero drift was measured at explanation of the sensor. ICP-related adverse events were also collected. Results Between 01/01/2018 and 31/03/2020, 235 patients were included in this study for a monitoring time of 2180 days. The zero-drift assessment was determined in 223 transducers (95%). The median duration of ICP monitoring was 8 days (interquartile [IQR] 4 to 13 days). The median zero drift was 1 mmHg (IQR 1 to 3) and a weak correlation was observed between the duration of ICP monitoring and zero drift (⍴=0.141; P = 0.0357), which lacks clinical significance. Zero drifts higher than 5 mmHg were found in 10% of transducers. Four patients (1.8%) had ICP-related hematomas, with no clinical impact, and none had ICP-related brain infection. Failures or technical dysfunctions of the monitoring were found in 6 patients (2.6%). Conclusion The Pressio catheter from the Sophysa system exhibited a minor zero drift after a median monitoring period of 8 days. This transducer's performance was comparable to that of other intracranial pressure devices utilizing strain gauge technology. Intracranial pressure monitoring neurointensive care zero drift Figures Figure 1 Figure 2 Introduction Since its first use described in 1951 1 , continuous intracranial pressure (ICP) monitoring has become an integrated part of neurocritical care monitoring to recognize secondary brain damages early. International guidelines have recommended the use of ICP monitoring for the management of patients with severe traumatic brain injury (TBI) 2 , 3 . This monitoring allows continuous measurement of ICP, calculation of cerebral perfusion pressure (CPP), and determination of patient’s autoregulation and brain compliance 4 . ICP monitoring was associated with more aggressive treatment and a lower mortality rate compared to no ICP monitoring 5 . The reliability of ICP measurements is critical for the optimal management of patients with severe brain injuries. ICP can be assessed using intra-parenchymal catheters, a method closely correlated with intra-ventricular pressure as the reference method 3 , 6 , 7 . There are two techniques to measure intra-parenchymal pressure: piezoelectric strain gauge technology or fiber optic technology. Although very accurate at the time of insertion, intra-parenchymal transducers show a degree of zero-drift over time, and they cannot be recalibrated after placement. This can result in a misinterpretation of the ICP value after several days 4 . Although there are data on the accuracy and zero-drift regarding the Codman Microsensor (Integra Lifesciences, Princeton, USA) 7 , 8 , the Raumedic Neurovent-P ICP (Raumedic, Helmbrechts, Germany) 9 and the Camino ICP Monitor (Natus, Middleton, USA) 10 , limited data exist with the Pressio catheter (Sophysa, Orsay, France). In vitro study found the Pressio transducer accurate to measure static and dynamic pressure 11 . Comparable accuracies between the Pressio and the Codman transducers were found in 30 patients with intra-ventricular pressure as reference 6 . Our aim was to assess the zero drift of the Pressio ICP sensor in vivo in a large cohort of unselected patients with acute brain injuries. Methods This prospective, observational study was conducted in 4 French intensive care units (ICU) of University Hospitals: Saint-Etienne, Clermont-Ferrand, Grenoble, and Rennes. Included patients required ICP monitoring according to the recommendations of international guidelines 2(p24),12 . The institutional review board of the University Hospital of Saint-Etienne approved the study design (IRBN652017/CHUSTE) on 30/11/2017 and, given its observational nature, waived the requirement for written informed consent from patients or relatives. The ICP monitoring system included the Pressio catheter and the Pressio 2 monitor (Sophysa, Orsay, France). The Pressio strain gauge microchip was encapsulated at the extremity of the catheter and connected through a specific dongle to the Pressio 2 monitor. This dongle saved the zero calibration data of the Pressio catheter and data were recorded at low-resolution frequency (1 Hz). The placement of the catheter was performed at the level of the Kocher’s point in the right frontal lobe, in the ICU or in the operative room, by a neurosurgeon or intensivist, using a specific bolt or a tunneled catheter. Prior to being inserted into the brain, the sensor tip was immersed in a saline solution for a calibration at pressure of 0 mmHg. Once the patient did not require ICP monitoring anymore, the ICP sensor was removed and immerged in a saline solution to be immediately assessed for the zero drift. Statistical analysis Data were expressed as median and inter-quartile ranges (IQR), and percentages. Coefficients of variation and intra-class correlation coefficients (ICC) were determined to test the reliability of zero drift per day of monitoring. Correlations between the drift and time of ICP monitoring were calculated using the Spearman’s rank correlation coefficient. Analyses were performed using GraphPad Software 8.3.0 (GraphPad Software, Boston, MA), and statistical significance was declared when p was less than 0.05. Results Between 01/01/2018 and 31/03/2020, 235 patients were enrolled in this study. The baseline characteristics of the population are shown in Table 1 . Table 1 Epidemiological data n (%) Median (IQR) Pathology Subarachnoidal haemorrage 50 (21,3) - Infections 10 (4,3) - Hemorragic stroke 12 (5,1) - Ischemic stroke 11 (4,7) - Intracerebral haemorrage 34 (14,5) - Traumatism Brain Injury 111 (47,2) - Others 7 (2,9) - Age 54 (37–64) Gender Male 151 (64) - Female 84 (36) - Initial Glasgow score 6,5 (4–9) Number of inclusions in each hospital Saint Etienne 98 (41,7%) - Rennes 70 (29,8%) - Grenoble 19 (8,1%) - Clermont Ferrand 48 (20,4%) - Of the 235 collected transducers, 12 (5%) were not assessed for the zero drift: 6 for technical reasons, 3 for accidental removal during nursing, and 3 for unavailability of assessors after explantation of the sensor. Of the 223 assessed transducers, the median zero drift was 1 mmHg (IQR 1 to 3) with extreme values ranged from − 9 to + 25 mmHg (Fig. 1 ). No zero drift was found in 47 transducers (21%). In 26 transducers (12%), a negative zero-drift was found with median − 1 mmHg [-2 to -1 mmHg] and values ranged from − 1 to -9 mmHg. The zero-drift was positive (+ 2 mmHg [+ 1 to + 4 mmHg]) in 150 transducers (67%) with values ranged from + 1 to + 25 mmHg. Drifts higher than 5 mmHg were found in 24 sensors (10%). Overall, the drift was equal or less than 2 mmHg in 151 transducers (68%). The median duration of ICP monitoring was 8 days (interquartile [IQR] 4 to 13 days). A weak correlation was observed between the duration of ICP monitoring and zero drift (⍴=0.141; P = 0.0357), which lacks clinical significance. ( Fig. 2 ). The variability of the drift over ICP monitoring time was 108%, with an ICC of 0.14. ICP-related hematomas were found in 4 patients (1.7%), all being less than 5 mm in diameter and with no clinical impact. No ICP-related brain infection was reported. Discussion This study shows that the Pressio transducer from the Sophysa system had a minor zero drift after a median 8-day monitoring study period. This zero-drift was comparable to other intracranial pressure devices using strain gauge technology. The drift of ICP transducers reveals deviation from the patient’s actual pressure and can alter the accuracy of ICP measurements over the monitoring time. Drift can be assessed in vivo once the transducer removed from the patient or in vitro in an artificial hydraulic system 13 . The causes of the drift may be due to the inability to mechanical problems of the probe and the material used. In a meta-analysis from clinical studies comparing simultaneous readings between an intra-parenchymal probe and a reference ICP measurement, the accuracy of various intra-parenchymal ICP monitoring systems was estimated 1.5 mmHg with a 95% confidence interval of 0.7–2.3 mmHg 14 . In that study, the reported mean drift over time was 0.75 mmHg. Our investigation on the zero-drift of the Pressio sensor (1 mmHg) is in line with that study. Moreover, no relation was found between the duration of Pressio sensor monitoring and the zero-drift, as found also elsewhere 14 In the present study, the drift ranged between − 9 and + 25 mmHg, a range comparable to the Camino ICP Monitor (-17 to + 21 mmHg) 10 , the Codman Microsensor (-6 to + 15 mmHg) 2 , 15 and the Raumedic Neurovent-P ICP (-4 mmHg to + 8 mmHg) 9 . Considering the accuracy of ICP measurement around 2–3 mmHg (see above), drifts higher than 5 mmHg should be a true source of concern. There were 24 Pressio transducers (10%) with a drift higher than 5 mmHg, a proportion smaller than reported with the Camino ICP Monitor (48%) 10 the Codman Microsensor (20%) 8 . In a bench test with the Raumedic Neurovent-P ICP transducer, the probability to have a drift of more than 3 mmHg was estimated to range between 12% and 17% 9 . The relatively few percent of high drift values with the Pressio catheter warrants further confirmation. The incidence of ICP-related hematomas (1.7%) with the Pressio sensor was close to other reported incidences in patients with no bleeding diathesis 7 , 10 . In a more recent study, hematomas less than 1 ml were however found in 27/549 patients (4.4%) using the Codman Microsensor device 16 . This study has several limitations. In this multicentre investigation, we are unable to exclude the possibility of slight differences in the use of the transducer, in particular the pre-insertion calibration and the post-removal assessment of the drift. In addition, we did not compare the accuracy of the sensor with intraventricular pressure measurements as the reference method. Finally, the causes of high values of zero-drift were unclear, as we did not document possible errors in the manipulation of the sensor. Conclusion The Pressio sensor from the Sophysa system exhibited a minor zero drift, comparable to that of other intracranial pressure devices utilizing strain gauge technology. The clinical results align closely with the in vitro data, confirming that the ICP measurements provided by this device are both reliable and accurate, ensuring confident clinical use. Declarations Conflict of interests : LG, RC and JFP have a conflict of interest with Sophysa due to receiving research grants, consulting fees, and support for congress registration and travel. The authors confirm: - that manuscript complies with all instructions to the authors - this manuscript has not been published elsewhere and is not under consideration by another journal - that the authorship requirements have been met and all authors approved the final manuscript. - adherence to ethical guidelines and indicate ethical approvals (IRB) and use of informed consent, as appropriate - disclose Conflicts of Interest for all authors - the use of a reporting checklist - This study did not receive specific funding. Each team monitored the drift value of the ICP probe and recorded the data at their respective hospital (KL (Grenoble), RC (Clermont Fd), JMo, CM (St Etienne) and YL (Rennes). LG, JMa, and CM compiled the data into a shared database and analysed the results. JMa, LG, JFP, and YL drafted the manuscript, while RC and YL contributed to revising and improving it. References GUILLAUME J. [Continuous intracranial manometry; importance of the method and first results]. Rev Neurol (Paris). 1951;84(2):131–42. Geeraerts T, Velly L, Abdennour L, et al. Management of severe traumatic brain injury (first 24hours). Anaesth Crit Care Pain Med. 2018;37(2):171–86. 10.1016/j.accpm.2017.12.001 . Sonig A, Jumah F, Raju B, Patel NV, Gupta G, Nanda A. The Historical Evolution of Intracranial Pressure Monitoring. World Neurosurg. 2020;138:491–7. 10.1016/j.wneu.2020.03.028 . Hawryluk GWJ, Citerio G, Hutchinson P, et al. Intracranial pressure: current perspectives on physiology and monitoring. Intensive Care Med. 2022;48(10):1471–81. 10.1007/s00134-022-06786-y . Robba C, Graziano F, Rebora P, et al. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. Lancet Neurol. 2021;20(7):548–58. 10.1016/S1474-4422(21)00138-1 . Lescot T, Reina V, Le Manach Y, et al. In vivo accuracy of two intraparenchymal intracranial pressure monitors. Intensive Care Med. 2011;37(5):875–9. 10.1007/s00134-011-2182-8 . Koskinen LOD, Olivecrona M. Clinical Experience with the Intraparenchymal Intracranial Pressure Monitoring Codman MicroSensor System. Neurosurgery. 2005;56(4):693–8. 10.1227/01.NEU.0000156609.95596.24 . Al-Tamimi YZ, Helmy A, Bavetta S, Price SJ. Assessment of zero drift in the Codman intracranial pressure monitor: a study from 2 neurointensive care units. Neurosurgery . 2009;64(1):94–98; discussion 98–99. 10.1227/01.NEU.0000328392.98602.5A Citerio G, Piper I, Chambers IR, et al. Multicenter clinical assessment of the Raumedic Neurovent-P intracranial pressure sensor: a report by the BrainIT group. Neurosurgery. 2008;63(6):1152–8. 10.1227/01.NEU.0000335148.87042.D7 . discussion 1158. Gelabert-González M, Ginesta-Galan V, Sernamito-García R, Allut AG, Bandin-Diéguez J, Rumbo RM. The Camino intracranial pressure device in clinical practice. Assessment in a 1000 cases. Acta Neurochir (Wien). 2006;148(4):435–41. 10.1007/s00701-005-0683-3 . Allin D, Czosnyka M, Czosnyka Z. Laboratory testing of the Pressio intracranial pressure monitor. Neurosurgery. 2008;62(5):1158–61. 10.1227/01.neu.0000325878.67752.eb . discussion 1161. Carney N, Totten AM, O’Reilly C, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6–15. 10.1227/NEU.0000000000001432 . Morgalla MH, Dietz K, Deininger M, Grote EH. The problem of long-term ICP drift assessment: improvement by use of the ICP drift index. Acta Neurochir (Wien) . 2002;144(1):57–60; discussion 60–61. 10.1007/s701-002-8274-2 Zacchetti L, Magnoni S, Di Corte F, Zanier ER, Stocchetti N. Accuracy of intracranial pressure monitoring: systematic review and meta-analysis. Crit Care. 2015;19. 10.1186/s13054-015-1137-9 . Gopinath SP, Robertson CS, Contant CF, Narayan RK, Grossman RG. Clinical evaluation of a miniature strain-gauge transducer for monitoring intracranial pressure. Neurosurgery . 1995;36(6):1137–1140; discussion 1140–1141. 10.1227/00006123-199506000-00011 Koskinen LOD, Grayson D, Olivecrona M. The complications and the position of the Codman MicroSensor ™ ICP device: an analysis of 549 patients and 650 Sensors. Acta Neurochir (Wien). 2013;155(11):2141–8. 10.1007/s00701-013-1856-0 . discussion 2148. Cite Share Download PDF Status: Published Journal Publication published 20 Jun, 2025 Read the published version in Neurocritical Care → Version 1 posted Reviewers agreed at journal 31 Jan, 2025 Reviewers invited by journal 29 Jan, 2025 Editor invited by journal 28 Jan, 2025 Editor assigned by journal 28 Jan, 2025 First submitted to journal 26 Jan, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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International guidelines have recommended the use of ICP monitoring for the management of patients with severe traumatic brain injury (TBI)\\u003csup\\u003e\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u003c/sup\\u003e. This monitoring allows continuous measurement of ICP, calculation of cerebral perfusion pressure (CPP), and determination of patient\\u0026rsquo;s autoregulation and brain compliance\\u003csup\\u003e\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e\\u003c/sup\\u003e. ICP monitoring was associated with more aggressive treatment and a lower mortality rate compared to no ICP monitoring\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eThe reliability of ICP measurements is critical for the optimal management of patients with severe brain injuries. ICP can be assessed using intra-parenchymal catheters, a method closely correlated with intra-ventricular pressure as the reference method\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u003c/sup\\u003e. There are two techniques to measure intra-parenchymal pressure: piezoelectric strain gauge technology or fiber optic technology. Although very accurate at the time of insertion, intra-parenchymal transducers show a degree of zero-drift over time, and they cannot be recalibrated after placement. This can result in a misinterpretation of the ICP value after several days\\u003csup\\u003e\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eAlthough there are data on the accuracy and zero-drift regarding the Codman Microsensor (Integra Lifesciences, Princeton, USA)\\u003csup\\u003e\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e\\u003c/sup\\u003e, the Raumedic Neurovent-P ICP (Raumedic, Helmbrechts, Germany)\\u003csup\\u003e\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e\\u003c/sup\\u003e and the Camino ICP Monitor (Natus, Middleton, USA)\\u003csup\\u003e\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e\\u003c/sup\\u003e, limited data exist with the Pressio catheter (Sophysa, Orsay, France). \\u003cem\\u003eIn vitro\\u003c/em\\u003e study found the Pressio transducer accurate to measure static and dynamic pressure\\u003csup\\u003e\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e\\u003c/sup\\u003e. Comparable accuracies between the Pressio and the Codman transducers were found in 30 patients with intra-ventricular pressure as reference\\u003csup\\u003e\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e\\u003c/sup\\u003e. Our aim was to assess the zero drift of the Pressio ICP sensor \\u003cem\\u003ein vivo\\u003c/em\\u003e in a large cohort of unselected patients with acute brain injuries.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cp\\u003e This prospective, observational study was conducted in 4 French intensive care units (ICU) of University Hospitals: Saint-Etienne, Clermont-Ferrand, Grenoble, and Rennes. Included patients required ICP monitoring according to the recommendations of international guidelines\\u003csup\\u003e2(p24),12\\u003c/sup\\u003e. The institutional review board of the University Hospital of Saint-Etienne approved the study design (IRBN652017/CHUSTE) on 30/11/2017 and, given its observational nature, waived the requirement for written informed consent from patients or relatives.\\u003c/p\\u003e \\u003cp\\u003eThe ICP monitoring system included the Pressio catheter and the Pressio 2 monitor (Sophysa, Orsay, France). The Pressio strain gauge microchip was encapsulated at the extremity of the catheter and connected through a specific dongle to the Pressio 2 monitor. This dongle saved the zero calibration data of the Pressio catheter and data were recorded at low-resolution frequency (1 Hz). The placement of the catheter was performed at the level of the Kocher\\u0026rsquo;s point in the right frontal lobe, in the ICU or in the operative room, by a neurosurgeon or intensivist, using a specific bolt or a tunneled catheter. Prior to being inserted into the brain, the sensor tip was immersed in a saline solution for a calibration at pressure of 0 mmHg. Once the patient did not require ICP monitoring anymore, the ICP sensor was removed and immerged in a saline solution to be immediately assessed for the zero drift.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eData were expressed as median and inter-quartile ranges (IQR), and percentages. Coefficients of variation and intra-class correlation coefficients (ICC) were determined to test the reliability of zero drift per day of monitoring. Correlations between the drift and time of ICP monitoring were calculated using the Spearman\\u0026rsquo;s rank correlation coefficient. Analyses were performed using GraphPad Software 8.3.0 (GraphPad Software, Boston, MA), and statistical significance was declared when p was less than 0.05.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eBetween 01/01/2018 and 31/03/2020, 235 patients were enrolled in this study. The baseline characteristics of the population are shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eEpidemiological data\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"4\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003en (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eMedian (IQR)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePathology\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eSubarachnoidal haemorrage\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50 (21,3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eInfections\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10 (4,3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eHemorragic stroke\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12 (5,1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eIschemic stroke\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11 (4,7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eIntracerebral haemorrage\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34 (14,5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eTraumatism Brain Injury\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e111 (47,2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eOthers\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e7 (2,9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e54 (37\\u0026ndash;64)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eGender\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eMale\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e151 (64)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eFemale\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e84 (36)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eInitial Glasgow score\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e6,5 (4\\u0026ndash;9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eNumber of inclusions in each hospital\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eSaint Etienne\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e98 (41,7%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eRennes\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e70 (29,8%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eGrenoble\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e19 (8,1%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e\\u003cem\\u003eClermont Ferrand\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e48 (20,4%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eOf the 235 collected transducers, 12 (5%) were not assessed for the zero drift: 6 for technical reasons, 3 for accidental removal during nursing, and 3 for unavailability of assessors after explantation of the sensor. Of the 223 assessed transducers, the median zero drift was 1 mmHg (IQR 1 to 3) with extreme values ranged from \\u0026minus;\\u0026thinsp;9 to +\\u0026thinsp;25 mmHg (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). No zero drift was found in 47 transducers (21%). In 26 transducers (12%), a negative zero-drift was found with median \\u0026minus;\\u0026thinsp;1 mmHg [-2 to -1 mmHg] and values ranged from \\u0026minus;\\u0026thinsp;1 to -9 mmHg. The zero-drift was positive (+\\u0026thinsp;2 mmHg [+\\u0026thinsp;1 to +\\u0026thinsp;4 mmHg]) in 150 transducers (67%) with values ranged from +\\u0026thinsp;1 to +\\u0026thinsp;25 mmHg. Drifts higher than 5 mmHg were found in 24 sensors (10%). Overall, the drift was equal or less than 2 mmHg in 151 transducers (68%).\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe median duration of ICP monitoring was 8 days (interquartile [IQR] 4 to 13 days). A weak correlation was observed between the duration of ICP monitoring and zero drift (⍴=0.141; P\\u0026thinsp;=\\u0026thinsp;0.0357), which lacks clinical significance. \\u003cb\\u003e(\\u003c/b\\u003eFig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e\\u003cb\\u003e).\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe variability of the drift over ICP monitoring time was 108%, with an ICC of 0.14.\\u003c/p\\u003e \\u003cp\\u003eICP-related hematomas were found in 4 patients (1.7%), all being less than 5 mm in diameter and with no clinical impact. No ICP-related brain infection was reported.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis study shows that the Pressio transducer from the Sophysa system had a minor zero drift after a median 8-day monitoring study period. This zero-drift was comparable to other intracranial pressure devices using strain gauge technology.\\u003c/p\\u003e \\u003cp\\u003eThe drift of ICP transducers reveals deviation from the patient\\u0026rsquo;s actual pressure and can alter the accuracy of ICP measurements over the monitoring time. Drift can be assessed \\u003cem\\u003ein vivo\\u003c/em\\u003e once the transducer removed from the patient or \\u003cem\\u003ein vitro\\u003c/em\\u003e in an artificial hydraulic system\\u003csup\\u003e\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e\\u003c/sup\\u003e. The causes of the drift may be due to the inability to mechanical problems of the probe and the material used. In a meta-analysis from clinical studies comparing simultaneous readings between an intra-parenchymal probe and a reference ICP measurement, the accuracy of various intra-parenchymal ICP monitoring systems was estimated 1.5 mmHg with a 95% confidence interval of 0.7\\u0026ndash;2.3 mmHg \\u003csup\\u003e\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e\\u003c/sup\\u003e. In that study, the reported mean drift over time was 0.75 mmHg. Our investigation on the zero-drift of the Pressio sensor (1 mmHg) is in line with that study. Moreover, no relation was found between the duration of Pressio sensor monitoring and the zero-drift, as found also elsewhere\\u003csup\\u003e\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e \\u003cp\\u003eIn the present study, the drift ranged between \\u0026minus;\\u0026thinsp;9 and +\\u0026thinsp;25 mmHg, a range comparable to the Camino ICP Monitor (-17 to +\\u0026thinsp;21 mmHg)\\u003csup\\u003e\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e\\u003c/sup\\u003e, the Codman Microsensor (-6 to +\\u0026thinsp;15 mmHg)\\u003csup\\u003e\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e\\u003c/sup\\u003e and the Raumedic Neurovent-P ICP (-4 mmHg to +\\u0026thinsp;8 mmHg)\\u003csup\\u003e\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e\\u003c/sup\\u003e. Considering the accuracy of ICP measurement around 2\\u0026ndash;3 mmHg (see above), drifts higher than 5 mmHg should be a true source of concern. There were 24 Pressio transducers (10%) with a drift higher than 5 mmHg, a proportion smaller than reported with the Camino ICP Monitor (48%)\\u003csup\\u003e10\\u003c/sup\\u003e the Codman Microsensor (20%)\\u003csup\\u003e8\\u003c/sup\\u003e. In a bench test with the Raumedic Neurovent-P ICP transducer, the probability to have a drift of more than 3 mmHg was estimated to range between 12% and 17%\\u003csup\\u003e9\\u003c/sup\\u003e. The relatively few percent of high drift values with the Pressio catheter warrants further confirmation.\\u003c/p\\u003e \\u003cp\\u003eThe incidence of ICP-related hematomas (1.7%) with the Pressio sensor was close to other reported incidences in patients with no bleeding diathesis\\u003csup\\u003e\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e\\u003c/sup\\u003e. In a more recent study, hematomas less than 1 ml were however found in 27/549 patients (4.4%) using the Codman Microsensor device\\u003csup\\u003e\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eThis study has several limitations. In this multicentre investigation, we are unable to exclude the possibility of slight differences in the use of the transducer, in particular the pre-insertion calibration and the post-removal assessment of the drift. In addition, we did not compare the accuracy of the sensor with intraventricular pressure measurements as the reference method. Finally, the causes of high values of zero-drift were unclear, as we did not document possible errors in the manipulation of the sensor.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eThe Pressio sensor from the Sophysa system exhibited a minor zero drift, comparable to that of other intracranial pressure devices utilizing strain gauge technology. The clinical results align closely with the in vitro data, confirming that the ICP measurements provided by this device are both reliable and accurate, ensuring confident clinical use.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e \\u003ch2\\u003e \\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003eConflict of interests\\u003c/span\\u003e:\\u003c/h2\\u003e \\u003cp\\u003eLG, RC and JFP have a conflict of interest with Sophysa due to receiving research grants, consulting fees, and support for congress registration and travel.\\u003c/p\\u003e\\u003cp\\u003eThe authors confirm:\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- that manuscript complies with all instructions to the authors\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- this manuscript has not been published elsewhere and is not under consideration by another journal\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- that the authorship requirements have been met and all authors approved the final manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- adherence to ethical guidelines and indicate ethical approvals (IRB) and use of informed consent, as appropriate\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- disclose Conflicts of Interest for all authors\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- the use of a reporting checklist\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;- This study did not receive specific funding. Each team monitored the drift value of the ICP probe and recorded the data at their respective hospital (KL (Grenoble), RC (Clermont Fd), JMo, CM (St Etienne) and YL (Rennes). LG, JMa, and CM compiled the data into a shared database and analysed the results. JMa, LG, JFP, and YL drafted the manuscript, while RC and YL contributed to revising and improving it.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eGUILLAUME J. [Continuous intracranial manometry; importance of the method and first results]. Rev Neurol (Paris). 1951;84(2):131\\u0026ndash;42.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGeeraerts T, Velly L, Abdennour L, et al. Management of severe traumatic brain injury (first 24hours). Anaesth Crit Care Pain Med. 2018;37(2):171\\u0026ndash;86. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.accpm.2017.12.001\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.accpm.2017.12.001\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSonig A, Jumah F, Raju B, Patel NV, Gupta G, Nanda A. The Historical Evolution of Intracranial Pressure Monitoring. World Neurosurg. 2020;138:491\\u0026ndash;7. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.wneu.2020.03.028\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.wneu.2020.03.028\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHawryluk GWJ, Citerio G, Hutchinson P, et al. Intracranial pressure: current perspectives on physiology and monitoring. Intensive Care Med. 2022;48(10):1471\\u0026ndash;81. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s00134-022-06786-y\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s00134-022-06786-y\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRobba C, Graziano F, Rebora P, et al. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. 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Neurosurgery. 2008;63(6):1152\\u0026ndash;8. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1227/01.NEU.0000335148.87042.D7\\u003c/span\\u003e\\u003cspan address=\\\"10.1227/01.NEU.0000335148.87042.D7\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. discussion 1158.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGelabert-Gonz\\u0026aacute;lez M, Ginesta-Galan V, Sernamito-Garc\\u0026iacute;a R, Allut AG, Bandin-Di\\u0026eacute;guez J, Rumbo RM. The Camino intracranial pressure device in clinical practice. Assessment in a 1000 cases. Acta Neurochir (Wien). 2006;148(4):435\\u0026ndash;41. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s00701-005-0683-3\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s00701-005-0683-3\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAllin D, Czosnyka M, Czosnyka Z. Laboratory testing of the Pressio intracranial pressure monitor. Neurosurgery. 2008;62(5):1158\\u0026ndash;61. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1227/01.neu.0000325878.67752.eb\\u003c/span\\u003e\\u003cspan address=\\\"10.1227/01.neu.0000325878.67752.eb\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. discussion 1161.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCarney N, Totten AM, O\\u0026rsquo;Reilly C, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6\\u0026ndash;15. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1227/NEU.0000000000001432\\u003c/span\\u003e\\u003cspan address=\\\"10.1227/NEU.0000000000001432\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMorgalla MH, Dietz K, Deininger M, Grote EH. The problem of long-term ICP drift assessment: improvement by use of the ICP drift index. \\u003cem\\u003eActa Neurochir (Wien)\\u003c/em\\u003e. 2002;144(1):57\\u0026ndash;60; discussion 60\\u0026ndash;61. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s701-002-8274-2\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s701-002-8274-2\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZacchetti L, Magnoni S, Di Corte F, Zanier ER, Stocchetti N. Accuracy of intracranial pressure monitoring: systematic review and meta-analysis. Crit Care. 2015;19. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1186/s13054-015-1137-9\\u003c/span\\u003e\\u003cspan address=\\\"10.1186/s13054-015-1137-9\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGopinath SP, Robertson CS, Contant CF, Narayan RK, Grossman RG. Clinical evaluation of a miniature strain-gauge transducer for monitoring intracranial pressure. \\u003cem\\u003eNeurosurgery\\u003c/em\\u003e. 1995;36(6):1137\\u0026ndash;1140; discussion 1140\\u0026ndash;1141. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1227/00006123-199506000-00011\\u003c/span\\u003e\\u003cspan address=\\\"10.1227/00006123-199506000-00011\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKoskinen LOD, Grayson D, Olivecrona M. The complications and the position of the Codman MicroSensor\\u003csup\\u003e\\u0026trade;\\u003c/sup\\u003e ICP device: an analysis of 549 patients and 650 Sensors. Acta Neurochir (Wien). 2013;155(11):2141\\u0026ndash;8. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s00701-013-1856-0\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s00701-013-1856-0\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. discussion 2148.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":true,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"neurocritical-care\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"neca\",\"sideBox\":\"Learn more about [Neurocritical Care](http://link.springer.com/journal/12028)\",\"snPcode\":\"12028\",\"submissionUrl\":\"https://www.editorialmanager.com/neca/default2.aspx\",\"title\":\"Neurocritical Care\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"Intracranial pressure, monitoring, neurointensive care, zero drift\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-5861409/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-5861409/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cb\\u003eObjective\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eMeasuring reliable intracranial pressure (ICP) is critical for patients with acute brain injuries. The aim of this study was to evaluate zero-drift of the intra-parenchymal strain gauge Pressio transducer (Sophysa, Orsay, France) in clinical conditions.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eMethods\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003e A prospective, observational multicentre study was conducted in 4 French intensive care units (ICU) of university hospitals. Patients with acute brain injuries were included if they needed ICP measurement using the Pressio transducer. The zero drift was measured at explanation of the sensor. ICP-related adverse events were also collected.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eResults\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eBetween 01/01/2018 and 31/03/2020, 235 patients were included in this study for a monitoring time of 2180 days. The zero-drift assessment was determined in 223 transducers (95%). The median duration of ICP monitoring was 8 days (interquartile [IQR] 4 to 13 days). The median zero drift was 1 mmHg (IQR 1 to 3) and a weak correlation was observed between the duration of ICP monitoring and zero drift (⍴=0.141; P\\u0026thinsp;=\\u0026thinsp;0.0357), which lacks clinical significance. Zero drifts higher than 5 mmHg were found in 10% of transducers. Four patients (1.8%) had ICP-related hematomas, with no clinical impact, and none had ICP-related brain infection. Failures or technical dysfunctions of the monitoring were found in 6 patients (2.6%).\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eConclusion\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eThe Pressio catheter from the Sophysa system exhibited a minor zero drift after a median monitoring period of 8 days. This transducer's performance was comparable to that of other intracranial pressure devices utilizing strain gauge technology.\\u003c/p\\u003e\",\"manuscriptTitle\":\"In vivo testing of the Pressio intracranial pressure monitor: the EPIC study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-02-04 08:54:10\",\"doi\":\"10.21203/rs.3.rs-5861409/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewerAgreed\",\"content\":\"\",\"date\":\"2025-01-31T15:05:03+00:00\",\"index\":0,\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2025-01-29T08:25:34+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"Neurocritical Care\",\"date\":\"2025-01-28T23:56:51+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2025-01-28T20:31:03+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Neurocritical Care\",\"date\":\"2025-01-26T14:52:54+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"neurocritical-care\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"neca\",\"sideBox\":\"Learn more about [Neurocritical Care](http://link.springer.com/journal/12028)\",\"snPcode\":\"12028\",\"submissionUrl\":\"https://www.editorialmanager.com/neca/default2.aspx\",\"title\":\"Neurocritical Care\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"5658cbd4-4738-4885-9a12-097a7fd34bee\",\"owner\":[],\"postedDate\":\"February 4th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"published-in-journal\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2025-06-23T16:05:10+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-5861409\",\"link\":\"https://doi.org/10.1007/s12028-025-02303-3\",\"journal\":{\"identity\":\"neurocritical-care\",\"isVorOnly\":false,\"title\":\"Neurocritical Care\"},\"publishedOn\":\"2025-06-20 15:57:48\",\"publishedOnDateReadable\":\"June 20th, 2025\"},\"versionCreatedAt\":\"2025-02-04 08:54:10\",\"video\":\"\",\"vorDoi\":\"10.1007/s12028-025-02303-3\",\"vorDoiUrl\":\"https://doi.org/10.1007/s12028-025-02303-3\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-5861409\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-5861409\",\"identity\":\"rs-5861409\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}