Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance

Sahu, Suman; Panda, Nidhi; Swain, Amlan; Mathew, Preethy J; Singla, Navneet; Gupta, Sunil; Jangra, Kiran; Bhardwaj, Avanish; Bhagat, Hemant

doi:10.7759/cureus.13008

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…Invasive methods for ICC measurement pose the risk of bleeding and infection. Hence, many studies have tried to estimate the equivalent of ICC indirectly based on the relationship of ICP and/or ICC with other noninvasive measurable parameters such as the optic nerve sheath diameter ( Sekhon et al, 2014 ; Sahu et al, 2021 ), transcranial Doppler outputs ( Bellner et al, 2004 ; Rockswold, 2004 ), the cranium characteristics ( Russegger and Ennemoser, 1990 ; Ueno et al, 1998 ; Mascarenhas et al, 2012 ), ICP pulse waveform ( Brasil et al, 2021 ), and cerebral blood flow characteristics ( Bateman, 2000 ; Egnor et al, 2001 ; Balédent et al, 2004 ). However, these methods have limitations and errors in ICC measurement ( Raksin et al, 2003 ; Kazimierska et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Gholampour

Yamini

Droessler

et al. 2022

Front. Bioeng. Biotechnol.

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The clinical application of intracranial compliance (ICC), ∆V/∆P, as one of the most critical indexes for hydrocephalus evaluation was demonstrated previously. We suggest a new definition for the concept of ICC (long-term ICC) where there is a longer amount of elapsed time (up to 18 months after shunting) between the measurement of two values (V1 and V2 or P1 and P2). The head images of 15 adult patients with communicating hydrocephalus were provided with nine sets of imaging in nine stages: prior to shunting, and 1, 2, 3, 6, 9, 12, 15, and 18 months after shunting. In addition to measuring CSF volume (CSFV) in each stage, intracranial pressure (ICP) was also calculated using fluid–structure interaction simulation for the noninvasive calculation of ICC. Despite small increases in the brain volume (16.9%), there were considerable decreases in the ICP (70.4%) and CSFV (80.0%) of hydrocephalus patients after 18 months of shunting. The changes in CSFV, brain volume, and ICP values reached a stable condition 12, 15, and 6 months after shunting, respectively. The results showed that the brain tissue needs approximately two months to adapt itself to the fast and significant ICP reduction due to shunting. This may be related to the effect of the “viscous” component of brain tissue. The ICC trend between pre-shunting and the first month of shunting was descending for all patients with a “mean value” of 14.75 ± 0.6 ml/cm H2O. ICC changes in the other stages were oscillatory (nonuniform). Our noninvasive long-term ICC calculations showed a nonmonotonic trend in the CSFV–ICP graph, the lack of a linear relationship between ICC and ICP, and an oscillatory increase in ICC values during shunt treatment. The oscillatory changes in long-term ICC may reflect the clinical variations in hydrocephalus patients after shunting.

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Section: Introductionmentioning

confidence: 99%

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Gholampour

Yamini

Droessler

et al. 2022

Front. Bioeng. Biotechnol.

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“…Therefore, intraoperative monitoring of ICP in such high-risk patients is necessary.Therefore, intraoperative monitoring of ICP in such high-risk patients is necessary.But there is no unified standard for evaluating ICP in non-craniocerebral surgery patients during the operation. Studies have shown that ultrasound monitoring of ONSD is a reliable bedside method to assess ICP [13,28], and different studies have different predictive values for intracranial hypertension [29][30]. In the two groups of patients in this study, the average ONSD in the Trendelenburg position and 60 min after pneumoperitoneum were significantly increased (4.5-5.0 mm) but did not reach the critical value of predicting intracranial hypertension (5.5 mm) [29].…”

Section: Discussionmentioning

confidence: 53%

“…Studies have shown that ultrasound monitoring of ONSD is a reliable bedside method to assess ICP [13,28], and different studies have different predictive values for intracranial hypertension [29][30]. In the two groups of patients in this study, the average ONSD in the Trendelenburg position and 60 min after pneumoperitoneum were significantly increased (4.5-5.0 mm) but did not reach the critical value of predicting intracranial hypertension (5.5 mm) [29]. Some studies have shown that when ONSD was at least 6 mm, ICP was greater than 20 mmHg [30].…”

Section: Discussionmentioning

confidence: 99%

Effect of individualized PEEP on lung ultrasound score and optic nerve sheath diameter in elderly patients undergoing laparoscopic radical resection of rectal cancer A Randomized,Single blind, Prospective Study

Bai,

Yin,

Wang

et al. 2023

Preprint

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Background: Intraoperative positive end-expiratory pressure (PEEP) has been promoted for many surgical procedures. However, whether PEEP has a dual protective effect on lung and brain is controversial,and the optimal PEEP associated with dual protection is unclear. The objective was to investigate the effects of individualized PEEP on lung ultrasound score (LUS) and optic nerve sheath diameter (ONSD) in elderly patients undergoing laparoscopic surgery. Methods: In total, 46 patients, aged 60～79 years, who underwent laparoscopic resection of rectal tumors from June 2022 to December 2022 were randomly divided into two groups:Groups E ( experimental group ,individualized PEEP guided by driving pressure) and Group C (control group ,PEEP = 5 cm H2O) . LUS was performed 30 min after operation. ONSD was measured at 5 min before anesthesia induction and various times post-surgery. The arterial oxygen index (OI) and arterial partial pressure of carbon dioxide (PaCO2) were recorded after tracheal tube insertion and before extubation at the end of the operation. Peak airway pressure (Ppeak), PETCO2, heart rate (HR), and mean arterial pressure (MAP) were also recorded. Postoperative pulmonary and neurological complications were followed up. Results: LUS in group E was significantly lower than that in group C at 30 min after surgery. The OI in group E was significantly higher than group C before extubation. There were no significant differences in the ONSD values between the two groups. ONSD of both groups increased significantly at 5 and 60 min after Trendelenburg positioning compared to before anesthesia induction. There were no significant differences between the two groups in Ppeak, PETCO2, HR, MAP at 5 min after tracheal tube insertion , no significant differences in the incidence of neurological and pulmonary complications . Conclusions: During laparoscopic radical resection of rectal cancer, application of individualized PEEP can reduce the LUS, improve patient oxygenation ,without causing an increase in neurological complications. Trial registration: This study was approved by the Ethics Committee of Chengdu Fifth People's Hospital, document number: AF/54/2020-02.3, approval number: 2022-026 (Study) -01. It has been registered on Chinese Clinical Trial Registry (ChiCTR2200060434,1/6/2022).

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“…In another study by Sahu et al, a significant correlation of ONSD with ICP (r = 0.532, p = 0.002) was found. An ONSD threshold of 5.5 mm predicted ICP > 20 mmHg with high sensitivity (100%) and specificity (75%) (area under receiver operating characteristic (ROC) curve = 0.904, p=0.01) in their study [14].…”

Section: Discussionmentioning

confidence: 90%

Effect of Orogastric Acetazolamide on Optic Nerve Sheath Diameter in Patients Undergoing Laparoscopic Donor Nephrectomies: A Randomized, Double-Blind Trial

Sen¹,

Goel²,

Aditya³

et al. 2022

Cureus

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IntroductionLaparoscopic Live Donor Nephrectomy(LLDN) is becoming an increasingly frequent procedure. The rise in intracranial pressure(ICP) during LLDN has not been measured yet. ICP can be evaluated by measuring ultrasonographic optic nerve sheath diameter(ONSD). Acetazolamide has been found to provide effective analgesia following LLDN. It also helps lowering the raised ICP. Therefore, we planned to study effect of orogastric Acetazolamide on ONSD in patients undergoing LLDN. MethodsForty Donors scheduled for LLDN were randomized preoperatively either into Group A receiving acetazolamide 5mg/kg or Group S receiving normal saline. ONSD was measured at time points:Time 0: In supine position before induction of GA, Time 1: 5 minutes after induction of GA but before giving orogastric acetazolamide, Time 2: 10 minutes after creating pneumoperitoneum, Time 3: 60 minutes after creating pneumoperitoneum, Time 4: Towards end of surgery, just before taking out specimen in modified flank position, Time 5: after extubating in supine position. ResultsMean ONSD of left eye(4.42 ± 0.48) in Group S was significantly more than mean ONSD of left eye(4.16 ± 0.15; p-0.036) in Group A at 10 mins after creating pneumoperitoneum in modified flank position. Mean ONSD showed significant increase in group S at 10 and 60 minutes(4.374 ± 0.433mm in group S vs 4.151 ± 0.168 in group A; p-0.042 at 10 mins and 4.336 ± 0.301mm in group S vs 4.149 ± 0.282mm in group A; p-0.050 at 60 mins) after creating pneumoperitoneum as compared to group A. ConclusionOrogastric acetazolamide 5 mg/kg was found to be beneficial in preventing rise in ONSD from 10 minutes to 1 hour of creating pneumoperitoneum in patients undergoing laparoscopic donor nephrectomy under general anaesthesia. Acetazolamide was also found to be effective in reducing postoperative pain.

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Optic Nerve Sheath Diameter: Correlation With Intra-Ventricular Intracranial Measurements in Predicting Dysfunctional Intracranial Compliance

Cited by 10 publications

References 28 publications

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

A New Definition for Intracranial Compliance to Evaluate Adult Hydrocephalus After Shunting

Effect of individualized PEEP on lung ultrasound score and optic nerve sheath diameter in elderly patients undergoing laparoscopic radical resection of rectal cancer A Randomized,Single blind, Prospective Study

Effect of Orogastric Acetazolamide on Optic Nerve Sheath Diameter in Patients Undergoing Laparoscopic Donor Nephrectomies: A Randomized, Double-Blind Trial

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