Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients |
| |
Authors: | Thomas Geeraerts Sybille Merceron Dan Benhamou Bernard Vigué Jacques Duranteau |
| |
Institution: | (1) AP-HP, Département d’Anesthésie-Réanimation Chirurgicale, Univ Paris-Sud, Centre Hospitalier Universitaire Bicêtre, 94275 Le Kremlin Bicêtre, France |
| |
Abstract: | Objective To assess the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in neurocritical care
patients.
Design Prospective, observational study.
Setting Surgical critical care unit, level 1 trauma center.
Patients A total number of 37 adult patients requiring sedation and ICP monitoring after severe traumatic brain injury, subarachnoid
hemorrhage, intracranial hematoma, or stroke.
Measurements and main results Optic nerve sheath diameter was measured with a 7.5 MHz linear ultrasound probe. ICP was measured invasively via a parenchymal
device. Simultaneous measurements were performed atleast once a day during the first 2 days after ICP insertion and in cases
of acute changes. There was a significant relationship between ONSD and ICP (78 simultaneous measures, r = 0.71, P < 0.0001). Changes in ICP were strongly correlated with changes in ONSD (39 measures, r = 0.73, P < 0.0001). Enlarged ONSD was a suitable predictor of elevated ICP (>20 mmHg) (area under ROC curve = 0.91). When ONSD was
less than 5.86 mm, the negative likehood ratio for raised ICP was 0.06.
Conclusion In sedated neurocritical care patients, non-invasive sonographic measurements of ONSD are correlated with invasive ICP, and
the probability to have raised ICP if ONSD is less than 5.86 mm is very low. This method could be used as a screening test
when raised ICP is suspected.
The authors received no financial support for this work. |
| |
Keywords: | Ocular ultrasound Traumatic brain injury Subarachnoid hemorrhage Elevated intracranial pressure Optic nerve sheath |
本文献已被 PubMed SpringerLink 等数据库收录! |
|