Intracranial Hypertension Clinical Trial
Official title:
Prospective Evaluation of Non-invasive Intracranial Pressure (ICP) Monitoring in Pediatric Patients Undergoing Invasive ICP Monitoring
The purpose of this study is to prospectively evaluate the accuracy and safety of non-invasive intracranial pressure (ICP) measurements using the HeadSense-1000 (HS-1000) device compared to the current invasive external ventricular device (EVD) or parenchymal (bolt) monitoring devices in the pediatric population.
The HS-1000 is an innovative non-invasive intracranial pressure (ICP) monitoring device that
employs advanced acoustic signal analysis to derive ICP on a continuous basis. The first
version of the device was clinically validated in trials in Italy, India, and Armenia.
Overall, more than 10,000 ICP measurements were collected from both patients and healthy
subjects. The device is currently undergoing FDA validation in an adult cohort across eight
sites in the United States.
This will be a pilot study conducted at Akron Children's Hospital. A maximum of 40 patients
with severe traumatic brain injury (TBI) or neurological conditions requiring ICP monitoring
will be studied over 2 years. All patients treated with either surgical ICP monitor
(external ventricular drain [EVD] or subarachnoid manometer [Bolt]) are eligible for study
enrollment. The HS-1000 device will be deployed as soon as possible after surgical ICP
monitor placement to record and collect data in parallel with the surgical device.
To assess the accuracy and safety of the HS-1000 device as an alternative to the invasive
ICP procedure, the investigators will compare ICP readings obtained by the HS-1000
monitoring system to measurements recorded by the surgical device during 15-30 minute
recording sessions.
ICP readings will be recorded from both the invasive and HeadSense non-invasive ICP monitor
for an aggregate of 30 minutes. During the recording sessions, a webcam will take periodic
snapshots of the ICP monitor and/or bedside monitor picturing the ICP values and other
clinical parameters that are displayed on screen, with a focus on blood pressure and heart
rate (HR). Recording sessions will be done until an aggregate of at least 30 minutes of data
are collected, depending on the patient's clinical condition. Recording sessions may be
repeated over several days until the 30 minute target is reached.
The HeadSense headset is removed between recordings. Recording should be done only in case
the patient's clinical condition allows it (i.e. patient is in supine position and does not
require any clinical intervention or treatment at the time of the recording). In case the
patient requires some clinical intervention the recording will be stopped and will be
resumed only after the intervention is done and the patient's clinical condition allows
resuming of the recording.
Lastly, the investigators will also place a commercial sound meter in the participant's room
to collect baseline data on exposure to ambient noise within the Pediatric Intensive Care
Unit (PICU) treatment environment. This data will facilitate a device-vs-ambient sound
comparison, a component of the device safety profile.
Study patient demographics will be collected to include patient medical record number, age,
gender, diagnosis, medical information, and the patient's clinical course pertinent to the
ICP monitoring until the attending physician determines invasive ICP measurement is no
longer necessary. Additional demographic, diagnostic parameters, severity of illness
calculations, and procedures will be obtained from the Virtual Pediatric Systems (VPS, LLC)
Pediatric Intensive Care Unit clinical outcomes database. The patient will be followed for
48 hours post ICU discharge for any adverse events.
The diagnosis of head trauma or other medical conditions indicating a need for ICP
monitoring, the decision to place an intraventricular catheter and the duration of ICP
monitoring are at the discretion of the patient's clinical care team and independent of this
study. With the exception of simultaneous use of the non-invasive acoustical HS-1000
monitoring system and ambient noise level measurements within the patient's room, all other
patient care, including clinical evaluations and treatments, is independent of this study.
No HS-1000 data will be displayed and will not be used in clinical decision making.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Screening
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