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      Chronically Implanted Pressure Sensors: Challenges and State of the Field

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          Abstract

          Several conditions and diseases are linked to the elevation or depression of internal pressures from a healthy, normal range, motivating the need for chronic implantable pressure sensors. A simple implantable pressure transduction system consists of a pressure-sensing element with a method to transmit the data to an external unit. The biological environment presents a host of engineering issues that must be considered for long term monitoring. Therefore, the design of such systems must carefully consider interactions between the implanted system and the body, including biocompatibility, surgical placement, and patient comfort. Here we review research developments on implantable sensors for chronic pressure monitoring within the body, focusing on general design requirements for implantable pressure sensors as well as specifications for different medical applications. We also discuss recent efforts to address biocompatibility, efficient telemetry, and drift management, and explore emerging trends.

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          Monitoring and interpretation of intracranial pressure.

          Derek J. Pickard, M Czosnyka (2004)
          Intracranial pressure (ICP) is derived from cerebral blood and cerebrospinal fluid (CSF) circulatory dynamics and can be affected in the course of many diseases of the central nervous system. Monitoring of ICP requires an invasive transducer, although some attempts have been made to measure it non-invasively. Because of its dynamic nature, instant CSF pressure measurement using the height of a fluid column via lumbar puncture may be misleading. An averaging over 30 minutes should be the minimum, with a period of overnight monitoring in conscious patients providing the optimal standard. Computer-aided recording with online waveform analysis of ICP is very helpful. Although there is no "Class I" evidence, ICP monitoring is useful, if not essential, in head injury, poor grade subarachnoid haemorrhage, stroke, intracerebral haematoma, meningitis, acute liver failure, hydrocephalus, benign intracranial hypertension, craniosynostosis etc. Information which can be derived from ICP and its waveforms includes cerebral perfusion pressure (CPP), regulation of cerebral blood flow and volume, CSF absorption capacity, brain compensatory reserve, and content of vasogenic events. Some of these parameters allow prediction of prognosis of survival following head injury and optimisation of "CPP-guided therapy". In hydrocephalus CSF dynamic tests aid diagnosis and subsequent monitoring of shunt function.
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            Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods—A Review

            P. Raboel, J Bartek, Jennifer M Andresen … (2012)
            Monitoring of intracranial pressure (ICP) has been used for decades in the fields of neurosurgery and neurology. There are multiple techniques: invasive as well as noninvasive. This paper aims to provide an overview of the advantages and disadvantages of the most common and well-known methods as well as assess whether noninvasive techniques (transcranial Doppler, tympanic membrane displacement, optic nerve sheath diameter, CT scan/MRI and fundoscopy) can be used as reliable alternatives to the invasive techniques (ventriculostomy and microtransducers). Ventriculostomy is considered the gold standard in terms of accurate measurement of pressure, although microtransducers generally are just as accurate. Both invasive techniques are associated with a minor risk of complications such as hemorrhage and infection. Furthermore, zero drift is a problem with selected microtransducers. The non-invasive techniques are without the invasive methods' risk of complication, but fail to measure ICP accurately enough to be used as routine alternatives to invasive measurement. We conclude that invasive measurement is currently the only option for accurate measurement of ICP.
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              Biocompatibility and biofouling of MEMS drug delivery devices.

              Gabriela Voskerician, Matthew S Shive, Rebecca Shawgo … (2003)
              The biocompatibility and biofouling of the microfabrication materials for a MEMS drug delivery device have been evaluated. The in vivo inflammatory and wound healing response of MEMS drug delivery component materials, metallic gold, silicon nitride, silicon dioxide, silicon, and SU-8(TM) photoresist, were evaluated using the cage implant system. Materials, placed into stainless-steel cages, were implanted subcutaneously in a rodent model. Exudates within the cage were sampled at 4, 7, 14, and 21 days, representative of the stages of the inflammatory response, and leukocyte concentrations (leukocytes/microl) were measured. Overall, the inflammatory responses elicited by these materials were not significantly different than those for the empty cage controls over the duration of the study. The material surface cell density (macrophages or foreign body giant cells, FBGCs), an indicator of in vivo biofouling, was determined by scanning electron microscopy of materials explanted at 4, 7, 14, and 21 days. The adherent cellular density of gold, silicon nitride, silicon dioxide, and SU-8(TM) were comparable and statistically less (p<0.05) than silicon. These analyses identified the MEMS component materials, gold, silicon nitride, silicon dioxide, SU-8(TM), and silicon as biocompatible, with gold, silicon nitride, silicon dioxide, and SU-8(TM) showing reduced biofouling.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Sensors (Basel)
                Journal ID (iso-abbrev): Sensors (Basel)
                Title: Sensors (Basel, Switzerland)
                Publisher: MDPI
                ISSN (Electronic): 1424-8220
                Publication date Collection: November 2014
                Publication date (Electronic): 31 October 2014
                Volume: 14
                Issue: 11
                Pages: 20620-20644
                Affiliations
                [1 ] Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, DRB-140, Los Angeles, CA 90089-1111, USA; E-Mails: lawrence.yu@ 123456usc.edu (L.Y.); brianjk@ 123456usc.edu (B.J.K.)
                [2 ] Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Ave, EEB-100, Los Angeles, CA 90089-2560, USA
                Author notes

                External Editors: Andrew J. Mason and Wen Li

                [* ] Author to whom correspondence should be addressed; E-Mail: ellis.meng@ 123456usc.edu ; Tel.: +1-213-740-6952; Fax: +1-213-821-3897.
                Article
                Publisher ID: sensors-14-20620
                DOI: 10.3390/s141120620
                PMC ID: 4279503
                PubMed ID: 25365461
                SO-VID: 6b220934-75de-433c-9e50-4b3b0ec23f24
                Copyright © © 2014 by the authors; licensee MDPI, Basel, Switzerland.
                License:

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                Date received : 27 June 2014
                Date revision received : 14 October 2014
                Date accepted : 21 October 2014
                Categories
                Subject: Article

                ScienceOpen disciplines: Biomedical engineering
                Keywords: implantable pressure sensors,implantable pressure transducers,biocompatibility,telemetry,drift
                Data availability:
                ScienceOpen disciplines: Biomedical engineering
                Keywords: implantable pressure sensors, implantable pressure transducers, biocompatibility, telemetry, drift

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