Intracranial pressure monitoring in childhood @entity693 with XXXX : a national survey of neurosurgeons in the United States.

@entity1 @entity1276 @entity428 @entity4 @entity16 @entity772 @entity693
OBJECTIVES: To describe the beliefs and attitudes of U.S. neurosurgeons regarding the use of intracranial pressure monitors among @entity772 @entity1 with @entity693 . DESIGN AND SETTING: A questionnaire was administered by mail between March and July 2009, to a random sample of 500 adult neurosurgeons and to all 228 pediatric neurosurgeons in the @entity16 . INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The response rate was 60%. Abnormal computed tomography scans, either with @entity4 or @entity1276 , and older @entity1 age were likely to prompt neurosurgeons to consider monitoring intracranial pressure, whereas etiology of @entity693 did not impact the decision to monitor intracranial pressure. Fifty-two percent of neurosurgeons believed computed tomography scans were inaccurate in detecting @entity428 in @entity772 @entity1 with @entity693 , 22% believed otherwise, and 26% were uncertain. Only 25% of neurosurgeons felt there was sufficient medical evidence to monitor intracranial pressure in @entity772 @entity1 with @entity693 , with higher frequency among adult than pediatric (30% vs. 16%; p < .01) neurosurgeons. Eighty-one percent of neurosurgeons disagreed with the notion that @entity772 @entity1 with @entity693 were too ill to benefit from placement of intracranial pressure monitors. Pediatric neurosurgeons reported a higher frequency than adult neurosurgeons of having placed more (more than five) intracranial pressure monitors in @entity772 @entity1 with @entity693 (42% vs. 28%; p < .01). CONCLUSIONS: Most neurosurgeons are willing to consider monitoring intracranial pressure among @entity772 @entity1 with @entity693 in the presence of abnormal findings on computed tomography scan and with older @entity1 age. These findings are instructive in view of the current uncertainty and equipoise in clinical practice regarding intracranial pressure monitoring in these critically ill @entity1 .
