NIMBI feasibility study
Research type
Research Study
Full title
Non-invasive measurement of intracranial pressure and cerebral oxygenation in paediatric brain injury
IRAS ID
142089
Contact name
Stephen Ray
Contact email
Sponsor organisation
Alder Hey Children's NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, days
Research summary
Brain injury occurs in 1-4 per 1000 children. Work in traumatic brain injury suggests that changes in pressure inside the skull (intracranial pressure) and amount of oxygen carried in blood circulating through blood vessels in the head (brain oxygenation) during the acute illness link with later disability. However, the relationship between brain pressure and/or brain oxygenation with disability in non-traumatic brain injury (e.g. brain infection) is unclear. Understanding these relationships will help guide management and improve outcome of children with brain injury.
Intracranial pressure is currently measured directly via a needle in the head (‘bolt’) or spine (lumbar puncture). However, intracranial pressure can be indirectly measured by movement of the eardrum using a cerebral and cochlear fluid pressure analyser (CCFP). Brain oxygenation is not routinely measured, but can be measured using light transmitted through the skull via near infrared spectroscopy (NIRS).
The primary aim of this pilot study is to confirm CCFP measurements are feasible and agree with direct measures (via ‘bolt’ or lumbar puncture) of intracranial pressure. Indirect and direct pressure measurements will be performed in two groups of children with suspected raised intracranial pressure; children with long-term illness, e.g. with chronically raised intracranial pressure (e.g. idiopathic intracranial hypertension) or children with acute illness, e.g. inflammation of the brain (encephalitis).
Secondary aims are to examine the relationships between intracranial pressure, brain oxygenation and clinical outcome (via a standardised score). We will also measure indicators of brain cell damage (e.g. S100ß) present in the cerebrospinal fluid (fluid bathing the brain) and blood and relate their abundance to clinical outcome.
Confirming CCFP as an accurate tool for measuring intracranial pressure will be of future benefit to patients, preventing them needing invasive measurements. Non-invasive measurements of intracranial pressure will also benefit doctors, guiding more dynamic management of children with brain injury.
REC name
North West - Haydock Research Ethics Committee
REC reference
14/NW/1403
Date of REC Opinion
20 Nov 2014
REC opinion
Favourable Opinion