Static and dynamic pupillometry for determination of the course of gradual detoxification of opiate-addicted patients

Grünberger, J; Linzmayer, L; Fodor, Georg; Presslich, O; Praitner, M.; Loimer, Norbert

doi:10.1007/bf02189980

Cited by 18 publications

(17 citation statements)

References 4 publications

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“…168 The MNAS was criticized for being subjective, clinically biased, and time-consuming. It included items that do not apply to children or ventilated patients, whereas other signs of the sedation-agitation spectrum (such as pupillary size 169 and responses to handling 170 ) were not included. Another method, the Sedation Withdrawal Score developed by Cunliffe et al, 171 included 12 symptoms of withdrawal, each scored subjectively on a 3-point scale.…”

Section: Clinical Management Of Opioid Tolerance and Withdrawalmentioning

confidence: 99%

Tolerance and Withdrawal From Prolonged Opioid Use in Critically Ill Children

et al. 2010

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OBJECTIVE After prolonged opioid exposure, children develop opioid-induced hyperalgesia, tolerance, and withdrawal. Strategies for prevention and management should be based on the mechanisms of opioid tolerance and withdrawal. PATIENTS AND METHODS Relevant manuscripts published in the English language were searched in Medline by using search terms “opioid,” “opiate,” “sedation,” “analgesia,” “child,” “infant-newborn,” “tolerance,” “dependency,” “withdrawal,” “analgesic,” “receptor,” and “individual opioid drugs.” Clinical and preclinical studies were reviewed for data synthesis. RESULTS Mechanisms of opioid-induced hyperalgesia and tolerance suggest important drug- and patient-related risk factors that lead to tolerance and withdrawal. Opioid tolerance occurs earlier in the younger age groups, develops commonly during critical illness, and results more frequently from prolonged intravenous infusions of short-acting opioids. Treatment options include slowly tapering opioid doses, switching to longer-acting opioids, or specifically treating the symptoms of opioid withdrawal. Novel therapies may also include blocking the mechanisms of opioid tolerance, which would enhance the safety and effectiveness of opioid analgesia. CONCLUSIONS Opioid tolerance and withdrawal occur frequently in critically ill children. Novel insights into opioid receptor physiology and cellular biochemical changes will inform scientific approaches for the use of opioid analgesia and the prevention of opioid tolerance and withdrawal.

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Section: Clinical Management Of Opioid Tolerance and Withdrawalmentioning

confidence: 99%

Tolerance and Withdrawal From Prolonged Opioid Use in Critically Ill Children

et al. 2010

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“…Automated computerized pupillometric systems have been developed in order to more accurately control the light stimulus and to record pupillary movements and have been used in various ways in a large number of medical subspecialities (Grünberger et al, 1990; McLaren et al, 2002; Rosen et al, 2002; Fliegert et al, 2005; Wilhelm et al, 2007; Kardon et al, 2009, 2011; Kawasaki et al, 2010). …”

Section: Introductionmentioning

confidence: 99%

Test–Retest Repeatability of the Pupil Light Response to Blue and Red Light Stimuli in Normal Human Eyes Using a Novel Pupillometer

Herbst¹,

Sander²,

Miléa³

et al. 2011

Front. Neur.

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In this study, we evaluated the repeatability of pupil responses to colored light stimuli in healthy subjects using a prototype chromatic pupillometer. One eye of 10 healthy subjects was tested twice in the same day using monochromatic light exposure at two selected wavelengths (660 and 470 nm, intensity 300 cd/m2) presented continuously for 20 s. Pupil responses were recorded in real-time before, during, and after light exposure. Maximal contraction amplitude and sustained contraction amplitude were calculated. In addition, we quantified the summed pupil response during continuous light stimulation as the total area between a reference line representing baseline pupil size and the line representing actual pupil size over 20 s (area under the curve). There was no significant difference in the repeated measure compared to the first test for any of the pupil response parameters. In conclusion, we have developed a novel prototype of color pupillometer which demonstrates good repeatability in evoking and recording the pupillary response to a bright blue and red light stimulus.

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“…O teste do reflexo pupilar à luz (Pupil Light Response) já foi utilizado em trabalhos anteriores na investigação de condições como alcoolismo [6], uso de drogas [7,8], síndrome de Down [9], depressão [10], entre outros.…”

Section: Introductionunclassified

Pupilometria Aplicada À Doença De Alzheimer

Silva¹,

Veiga²,

Silva³

2018

Anais Do v Congresso Brasileiro De Eletromiografia E Cinesiologia E X Simpósio De Engenharia Biomédica

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Resumo: A doença de Alzheimer (DA), em seu exercício clínico, por ainda não possuir marcadores de diagnóstico precisos, está condicionada à avaliação médica para determinar a hipótese principal geradora da doença. Este trabalho tem por finalidade investigar o comportamento e os parâmetros de resposta da pupila em um grupo de pacientes com a doença de Alzheimer e correlacionar com outro grupo sem o quadro clínico da doença. O método de investigação proposto é a pupilometria embarcada num protótipo portátil de baixo custo, que consiste numa análise não invasiva para aferir de forma dinâmica o tamanho e outros parâmetros da pupila durante um ciclo pupilar utilizando um estímulo luminoso. Palavras-chave:Pupilometria, Diagnóstico, Alzheimer, DA, PLR. Este trabalho tem por objetivo principal investigar o comportamento e os parâmetros de resposta da pupila ao estímulo luminoso, entre um grupo de pacientes com doença de Alzheimer e outro grupo sem o diagnóstico da doença ou outra demência. O método de investigação proposto é a pupilometria, que consiste numa análise não invasiva para aferir de forma dinâmica o tamanho da pupila durante um ciclo pupilar utilizando um estímulo luminoso. Um ciclo pupilar consiste no movimento de contração da pupila, seguido por uma expansão e em sequência retornando ao estado inicial [11]. A grande vantagem é que a análise via software da pupilometria foi desenvolvida e embarcada num protótipo portátil de baixíssimo custo utilizando linguagem computacional de código aberto. Abstract Materiais e métodosA presente pesquisa ainda está em andamento e possui caráter exploratório visando avaliar a possibilidade do uso da tecnologia desenvolvida como biomarcador. O Ambulatório de Psiquiatria do Hospital das Clínicas da Universidade Federal de Uberlândia (UFU) é a instituição coparticipante dessa pesquisa, conforme parecer aprovado no Comitê de Ética em 21 de outubro de 2016 sob o número 1.787.215.O equipamento utilizado na coleta de amostras, denominado de protótipo, e os demais materiais e métodos são descritos a seguir:Raspberry Pi 2 -é um dispositivo integrado com processador quad-core ARM Cortex-A7, 1 GB de memória RAM, 40 pinos GPIO (General Purpose Input Output) e quatro portas USB, conforme Figura 1. As portas de entrada e saída GPIO são utilizadas no controle dos estímulos luminosos incidentes no olho durante a captura do ciclo pupilométrico.

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Static and dynamic pupillometry for determination of the course of gradual detoxification of opiate-addicted patients

Cited by 18 publications

References 4 publications

Tolerance and Withdrawal From Prolonged Opioid Use in Critically Ill Children

Tolerance and Withdrawal From Prolonged Opioid Use in Critically Ill Children

Test–Retest Repeatability of the Pupil Light Response to Blue and Red Light Stimuli in Normal Human Eyes Using a Novel Pupillometer

Pupilometria Aplicada À Doença De Alzheimer

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