Telemetric ICP-monitoring in children; a national questionnaire-based study

Purpose: Telemetric monitoring of intracranial pressure (ICP) facilitates long-term measurements and home-monitoring, thus potentially reducing diagnostic imaging and acute hospital admissions in favour of outpatient appointments. Especially in pediatric patients, telemetric ICP-monitoring requires a high level of collaboration and compliance from patients and parents. In this study, we aim to systematically investigate 1) patient- and parent perception of telemetric ICP system utility and 2) hospital contact history and thus potential cost-benefit of telemetric ICP monitoring in pediatric patients with a cerebrospinal fluid disorder. Methods We conducted a nationwide questionnaire study including pediatric patients with either a current or previous telemetric ICP sensor and their parents. Additionally, a retrospective review of electronic health records for all included children was performed. Results We included 16 children (age range 3-16 years), with a total of 41 telemetric ICP sensors implanted. Following sensor implantation, the frequency of telephone contacts and outpatient visits increased. No corresponding decrease in either hospital admissions or total length of stay was found. The telemetric ICP sensor provided most parents with an improved sense of security and was seen as a necessary and valuable tool in treatment guidance. Size and shape of the sensor itself were reported as a disadvantage, while the external monitoring equipment was reported as easy to use, but too large and heavy for a child to carry. Conclusion Though, in quantitative terms, there was no cost-benefit of the telemetric ICP sensor, it contributes to an extended parental involvement and a sense of improved safety.