Sophysa Pressio PSO-PT Manual De Instrucciones página 7

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ncomplete tightening of the locking scRew will pRevent the adjustable stop fRom playing
,
its Role with the Risk of dRilling too deeply
The drill bit is then fixed to a helical drill and the perforation is performed through
the internal and external skull plates. The surgeon must ensure that any possibility
of a parenchymal lesion when he crosses the internal plate is avoided.
After having crossed the internal plate, the drill bit is withdrawn and the hole
is irrigated with sterile normal saline.
Incise the dura mater.
Technique recommended for tunneling
- Make a small incision at the chosen site for the emergence of the catheter
(Figure 3.1).
- Starting at the incision for the burr hole, insert the tunneling needle between
the scalp and the skull in the direction of the chosen site for the emergence
of the catheter (Figure 3.2).
- Remove the stylet from the needle
- Delicately thread the catheter into the needle from the emergence site
(distal) in the direction of the implantation site (proximal) (Figure 3.4). Make
sure at least 15cm of catheter has been threaded into the needle towards
the implantation site.
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he end of the tunneling needle is shaRp
- Remove the needle from under the scalp, over the top of the end
of the catheter (Figure 3.5).
Catheter implantation
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imit the Repetition of intRaceRebRal catheteR implantations
into the bRain to enable the inseRtion of the catheteR could pRedispose it to edema
,
and intRaceRebRal hemoRRhage Resulting in a Rise in intRacRanial pRessuRe
Ensure that the pressure sensor has been zeroed beforehand (cf. § "Preparation
of a Pressio® catheter BEFORE IMPLANTATION: zeroing the pressure sensor").
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d "sensoR zeRo"
o not peRfoRm the once the catheteR is implanted
"sensoR zeRo"
the befoRe it is implanted to calibRate it with atmospheRic pRessuRe
To perform a parenchymal measurement of intracranial pressure, the implantation
depth must be 1-3cm in the cerebral parenchyma.
- Introduce the catheter into the parenchyma to the required implantation
depth taking into account the thickness of the skull (Figure 3.6). Lightly stitch
the catheter where it exits the skull.
Catheter fixation
- Hold the catheter in place at the implantation site and pull very gently on the end
located at the side of the connector until it forms a right angle and rests flat
against the skull (Figure 3.7).
- Close the incision above the burr hole in compliance with standard hospital
procedures.
- Use the fixation tab supplied to fix the catheter on the scalp at the site where
it emerges (Figure 3.8).
- To keep the catheter in place and reduce the tension, roll the catheter and
attach the loop thus formed. Make sure no traction is exercised on the fixation
tab during these stages.
.
(Figure 3.3).
: .
intRoduce the catheteR veRy caRefully
:
fRequent incisions
.
;
it is essential to peRfoRm
At this stage the Pressio® monitor displays the mean intracranial pressure in mmHg.
Specific case for the PSO-PTT:
At this stage, the Pressio® monitor displays the mean intracranial pressure in mmHg.
The temperature is also displayed and will stabilize at its precise value in a maximum
of 150 seconds.
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a
tempeRatuRe measuRement can only be accuRate if the sensoR is implanted
is not suitable foR measuRing tempeRatuRe in the aiR
In both cases (PSO-PT and PSO-PTT), instability in the pressure value, the appearance
of error codes "E001", "E002", "E005" or the message "CONNECT SENSOR" on the Pressio®
monitor after connecting the catheter to the extension cable may be a sign of
an incorrect connection.
In this case, make sure that the catheter connector is pushed right up to the stop in
the catheter extension cable, and that the latter is correctly connected to the Pressio®
monitor.
The appearance of error codes "- - -", "999", "E001", "E002", "E005" or the message
"CONNECT SENSOR" on the Pressio® monitor after implantation of the catheter, even
though the catheter is correctly connected, may be a sign that the sensor on the end
of the catheter is damaged.
In this case, try to reposition the catheter, and if it fails again, try with a new catheter.
The maximum recommended duration for the catheter to be implanted is 5 days.
After the first 24 hours the Pressio® monitor displays the duration of implantation
for the catheter in the form of a message "Implantation: X days". This is then shown
throughout the implantation period.
This message starts to flash on the Pressio® monitor from the 6th day of implantation
meaning that the catheter has exceeded the recommended implantation duration.
If the Pressio® interface is used, the diode showing the implantation duration for the catheter
will flash as soon as the catheter exceeds the recommended implantation duration.
Once the catheter is implanted it can be disconnected and then reconnected
to the same or another unit from the Pressio® range (PSO-3000 software V2,
PSO-3000 software V1, PSO-IN00) without the necessity of recalibration to atmospheric
pressure. In fact, the monitoring catheter keeps all the zeroing data in the memory.
Remark:
It is also possible to implant the catheter sub-durally.
The implantation of the catheter in such cases (this is not normal use) is performed
under the responsibility of an anesthetist or an experienced neurosurgeon.
.
The clinical condition of the patient must, therefore, be subject to increased
surveillance.
Fold the catheter to mark an elbow. The section between the elbow and the end
of the catheter will be implanted sub-durally. The elbow must be made so that
the sensor or sensors are directed facing the cortex once the catheter is implanted.
To implant the catheter, insert its end through the pre-perforated dura mater and
push until it reaches the interior of the sub-dural space.
Recommended stages for explantation of the catheter
- Stop the Pressio® monitor.
- Disconnect the catheter from the extension cable.
- Proceed with the explantation of the catheter.
- Check the integrity of the explanted catheter.
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he sensoR
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