Does Optic Nerve Sheath Diameter Ultrasonography Permit Accurate Detection of Real-Time Changes in ICP?

Lesky, Daniel N.; Schott, Christopher K.

doi:10.12788/emed.2016.0042

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Ellingsen et al showed that the CBF response started less than 30 s after the PaCO 2 began to increase, and that it required up to 2 min to reach a peak value 20 . Changes in the ICP are rapidly transmitted to the optic nerve sheath, with no apparent temporal lag 21 . In the present study, the EtCO 2 showed a peak value immediately after deflation, but the ONSD, which is an indicator of the ICP, showed the highest value after 5 min of deflation.…”

Section: Discussionmentioning

confidence: 99%

Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study

Kim

et al. 2022

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Applying a pneumatic tourniquet provides surgeons with a bloodless surgical field. However, application of the tourniquet induces various physiological changes. We evaluated the effect of tourniquet deflation on the intracranial pressure by using ultrasonography to measure the optic nerve sheath diameter (ONSD) in patients undergoing lower limb surgery. The ONSD was measured in 20 patients at five time points: after anesthetic induction (T0) and immediately before (T1), immediately after (T2), 5 min after (T3), and 10 min after tourniquet deflation (T4). Hemodynamic and respiratory variables were recorded. The ONSD showed significant differences at each point (P < 0.001). The ONSDs at T2 and T3 were significantly greater than that at T1 (P = 0.0007 and < 0.0001, respectively). The change in the end-tidal carbon dioxide partial pressure (EtCO2) was similar to the change in the ONSD. The change in the ONSD was significantly correlated with the change in the EtCO2 after tourniquet deflation (r = 0.484, P = 0.030). In conclusion, the ONSD, as an indicator of intracranial pressure, increased after tourniquet deflation in patients undergoing lower limb surgery. This was correlated with an increased EtCO2 and arterial carbon dioxide partial pressure.Trial registration: ClinicalTrials.gov (NCT03782077).

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Section: Discussionmentioning

confidence: 99%

Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study

Kim

et al. 2022

Sci Rep

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A comparison of non-invasive versus invasive measures of intracranial pressure in hypoxic ischaemic brain injury after cardiac arrest

et al. 2019

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Aim: Increased intracranial pressure (ICP) in hypoxic ischaemic brain injury (HIBI) can cause secondary ischaemic brain injury and culminate in brain death. Invasive ICP monitoring is limited by associated risks in HIBI patients. We sought to evaluate the agreement between invasive ICP measurements and non-invasive estimators of ICP (nICP) in HIBI patients. Methods: Eligible consecutive adult (age > 18) cardiac arrest patients with HIBI were included as part of a single center prospective interventional study. Invasive ICP monitoring was undertaken and nICP measurements were undertaken using: a) transcranial Doppler ultrasonography (TCD), b) optic nerve sheet diameter ultrasound (ONSD) and c) jugular venous bulb pressure (JVP). Multiple measurements applied in linear mixed-effects models were considered to obtain the correlation coefficient between ICP and nICP as well as their prediction ability to detect intracranial hypertension (ICP ≥20 mm Hg). Results: Eleven patients were included (median age of 47 [range 20-71], 8 male and 3 female). There was a linear relationship between ICP and nICP with ONSD (R=0.53 [p<0.0001]), JVP (R=0.38 [p<0.001]) and TCD (R=0.30 [p<0.01]). The ability to predict intracranial hypertension was highest for ONSD and TCD (AUC=0.96 [95% CI: 0.90-1.00] and AUC=0.91 [95% CI: 0.83-1.00], respectively). JVP presented the weakest prediction ability (AUC=0.75 [95% CI: 0.56-0.94]). Conclusions: ONSD and TCD methods demonstrated agreement with invasively-monitored ICP, suggesting their potential roles in the detection of intracranial hypertension in HIBI after cardiac arrest.

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Does Optic Nerve Sheath Diameter Ultrasonography Permit Accurate Detection of Real-Time Changes in ICP?

Cited by 2 publications

References 12 publications

Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study

Change in the optic nerve sheath diameter after deflation of a pneumatic tourniquet: a prospective observational study

A comparison of non-invasive versus invasive measures of intracranial pressure in hypoxic ischaemic brain injury after cardiac arrest

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