Optimal timing to measure optic nerve sheath diameter as a prognostic predictor in post-cardiac arrest patients treated with targeted temperature management

Park, Jung Soo; You, Yeonho; Min, Jin Hong; Jeong, Wonjoon; Ahn, Hong Joon; Kang, Changshin; Yoo, In Seol; Ryu, Seung Ho; Lee, Jinwoong; Kim, Seung Whan; Cho, Sung Uk; Oh, Se Kwang; Lee, Junwan

doi:10.1016/j.resuscitation.2019.07.004

Cited by 21 publications

(26 citation statements)

References 25 publications

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“…However, this study did not include ultrasound studies conducted within a 6‐hour window from return of spontaneous circulation or in the ED. In a subsequent study evaluating optic nerve sheath diameter in 36 patients by 1 operator immediately post‐return of spontaneous circulation and at 24‐, 48‐, and 72‐hour intervals, there was no correlation with measurements obtained immediately post‐return of spontaneous circulation and patient outcome 51 . At 24 hours, the authors found that an optic nerve sheath diameter over 4.9 mm had a sensitivity of 83.3% and a specificity of 94.4% and a PPV of 93.7% for predicting a poor neurologic outcome.…”

Section: Imaging Studiesmentioning

confidence: 90%

Neurologic prognostication after resuscitation from cardiac arrest

2020

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Out‐of‐hospital cardiac arrest remains a leading cause of mortality in the United States, and the majority of patients who die after achieving return of spontaneous circulation die from withdrawal of care due to a perceived poor neurologic prognosis. Unfortunately, withdrawal of care often occurs during the first day of admission and research suggests this early withdrawal of care may be premature and result in unnecessary deaths for patients who would have made a full neurologic recovery. In this review, we explore the evidence for neurologic prognostication in the emergency department for patients who achieve return of spontaneous circulation after an out‐of‐hospital cardiac arrest.

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Section: Imaging Studiesmentioning

confidence: 90%

Neurologic prognostication after resuscitation from cardiac arrest

2020

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“…In today's practice, USG-mediated ONSDm has become more preferred compared to other non-invasive methods due to its bedside applicability, reproducibility, and easy accessibility to show pressure increase (16)(17)(18). And during the uses of this method, the accepted upper limit of normal ONSD values are < 5.0 mm for adults (>15 years of age), 4.5 mm for children and 4.0 mm for infants (19).…”

Section: Discussionmentioning

confidence: 99%

Determination of normal values of optic nerve sheath diameter in Turkish adult population using magnetic resonance imaging

Eroğlu¹,

Yönak²,

İslam³

et al. 2021

J Exp Clin Med

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The measurement of optic nerve sheath diameter (ONSD) is a reliable tool for the estimation of increased intracranial pressure (ICP). However, it is known that racial changes can occur in human anatomy. In the present study we aimed to determine the normal values of ONSD in Turkish adult population. This retrospective study involved the collection of data between June 1, 2015, and May 31, 2019, and was conducted on 291 adults known to have no increased cranial/intraocular pressure. The ONSD was measured at 3 mm posterior to the globe on MR images. 291 subjects were enrolled, 63.6% of whom were female. The total median ONSD was 4.40mm (4.20- 4.70). The median ONSD of the male participants was 4.50mm (4.25-4.75), of the female participants was 4.35mm (4.15-4.50) and the difference was statistically significant (p = 0.001). According to statistical analysis, it was found that only the presence of chronic renal failure altered the median of ONSD among the comorbid diseases (p = 0.042). Monitoring and treating increased ICP is crucial. Thanks to an ONSD with a known normal value, recognition and emergency management of this pathology would be easier. We think our study is noteworthy because it is the first study investigating the normal ONSD value in Turkish adult population.

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“…133 ONSD findings did not differ significantly with TTM, and an ONSD of 4.90 mm or more measured 24 hours after ROSC achieved an AUC of 0.91 in predicting poor neurologic outcome, and 24 h was a better time point compared with 48 and 72 hours after ROSC. 134…”

Section: Measurements Of Intracranial Pressure (Icp)mentioning

confidence: 99%

Targeted temperature management and early neuro-prognostication after cardiac arrest

Chen

Lachance

Gao

et al. 2021

J Cereb Blood Flow Metab

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Targeted temperature management (TTM) is a recommended neuroprotective intervention for coma after out-of-hospital cardiac arrest (OHCA). However, controversies exist concerning the proper implementation and overall efficacy of post-CA TTM, particularly related to optimal timing and depth of TTM and cooling methods. A review of the literature finds that optimizing and individualizing TTM remains an open question requiring further clinical investigation. This paper will summarize the preclinical and clinical trial data to-date, current recommendations, and future directions of this therapy, including new cooling methods under investigation. For now, early induction, maintenance for at least 24 hours, and slow rewarming utilizing endovascular methods may be preferred. Moreover, timely and accurate neuro-prognostication is valuable for guiding ethical and cost-effective management of post-CA coma. Current evidence for early neuro-prognostication after TTM suggests that a combination of initial prediction models, biomarkers, neuroimaging, and electrophysiological methods is the optimal strategy in predicting neurological functional outcomes.

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Optimal timing to measure optic nerve sheath diameter as a prognostic predictor in post-cardiac arrest patients treated with targeted temperature management

Cited by 21 publications

References 25 publications

Neurologic prognostication after resuscitation from cardiac arrest

Neurologic prognostication after resuscitation from cardiac arrest

Determination of normal values of optic nerve sheath diameter in Turkish adult population using magnetic resonance imaging

Targeted temperature management and early neuro-prognostication after cardiac arrest

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