scholarly journals Evaluation of the relationship between NIRS (near-infrared spectroscopy) and optic nerve sheath diameter measurement in children with increased intracranial pressure: a pilot study

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Didar Arslan ◽  
Dinçer Yıldızdaş ◽  
Özden Özgür Horoz ◽  
Nagehan Aslan ◽  
Faruk İncecik
Keyword(s):  
Infrared Spectroscopy ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Near Infrared ◽  
Optic Nerve Sheath Diameter ◽  
Increased Intracranial Pressure ◽  
Mean Values ◽  
Nerve Sheath ◽  
The Mean ◽  
Increased Icp

Abstract Background The increased intracranial pressure (ICP) syndrome may emerge depending on many different neurological factors and the early diagnosis and treatment are important for the prevention of neurologic damage and related mortality. In recent years, the follow-up of increased ICP with non-invasive methods has been rising. In this study, our objective was to determine the significance and any possible correlation between Optic Nerve Sheath Diameter (ONSD) and Near Infrared Spectroscopy (NIRS) in children with increased ICP. Methods Patients who were hospitalized in our pediatric ICU at Çukurova University Medical Faculty between June 2018 and June 2019 due to the suspicion of increased ICP were included in this study. The demographic characteristics of patients, diagnosis at admission, results of the cranial CT and MRI examinations, and results of the simultaneous ONSD and NIRS measurements were recorded. Results A total of 36 patients were included in our study. With respect to the diagnosis, non-traumatic causes were at the forefront in 30 patients (83.3%), and the most common causes were meningoencephalitis (n = 9; 25%) and non-traumatic bleeding (n = 7; 19.4%). Six of the patients were under the age of one year (16.7%), and the mean values of ONSD and NIRS were 4.8 ± 0.7 mm and 71.1 ± 12.4% respectively in this group. Fourteen patients were in the one to ten year age group and the mean values of ONSD and NIRS were 6.1 ± 0.6 mm and 72.7 ± 9.3% respectively. Sixteen patients were over ten years of age (44.4%), and the mean values of ONSD and NIRS were 5.6 ± 0.7 mm and 74.2 ± 16% respectively. There was no correlation between the ONSD and NIRS values (r:0.307; p = 0.068). Conclusion Our study showed that ONSD measurements were helpful in children with increased ICP and reflected the increase in ICP. However, our study also demonstrated that ONSD was not in correlation with the NIRS monitoring. We believe that there is a need for further studies focused on the use of ONSD and NIRS in the monitoring of increased ICP.

Evaluation of the Relationship Between NIRS (Near-Infrared Spectroscopy) and Optic Nerve Sheath Diameter Measurement in Children with Increased Intracranial Pressure: A Pilot Study

2020 ◽  
Author(s):  
Didar Arslan ◽  
Dinçer Yildizdas ◽  
Özden ÖZGÜR HOROZ ◽  
Nagehan Aslan ◽  
Faruk İNCECİK
Keyword(s):  
Infrared Spectroscopy ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Near Infrared ◽  
Optic Nerve Sheath Diameter ◽  
Increased Intracranial Pressure ◽  
Mean Values ◽  
Nerve Sheath ◽  
The Mean ◽  
Increased Icp

Abstract Background: The increased intracranial pressure (ICP) syndrome may emerge depending on many different neurological factors and the early diagnosis and treatment are important for the prevention of neurologic damage and related mortality. In recent years, the follow-up of increased ICP with non-invasive methods has been increasing. In this study, our objective was to determine the significance of ONSD (Optic Nerve Sheath Diameter) and NIRS (Near-Infrared Spectroscopy) in children with increased ICP and any possible correlation between ONSD and NIRS. Methods: Patients who were hospitalized in our pediatric ICU at Çukurova University Medical Faculty between June 2018 and June 2019 due to the suspicion of increased ICP were included in this study. The demographic characteristics of patients, diagnosis at admission, results of the cranial CT and MRI examinations, and results of the simultaneous ONSD and NIRS measurements were recorded. Results: A total of 36 patients were included in our study. With respect to the diagnosis, non-traumatic causes were at the forefront in 30 patients (83.3%), and the most common causes were meningoencephalitis (n=9; 25%) and non-traumatic bleeding (n=7; 19.4%). Six of the patients were under the age of one year (16.7%), and the mean values of ONSD and NIRS were 4.8±0.7 mm and 71.1±12.4% respectively in this group. Fourteen patients were in the one to ten year age group and the mean values of ONSD and NIRS were 6.1±0.6 mm and 72.7±9.3% respectively. Sixteen patients were over ten years of age (44.4%), and the mean values of ONSD and NIRS were 5.6±0.7 mm and 74.2±16% respectively. There was no correlation between the ONSD and NIRS values (r:0.3; p=0.07).Conclusion: Our study showed that ONSD measurements were helpful in children with increased ICP and reflected the increase in ICP. However, our study also demonstrated that ONSD was not in correlation with the NIRS monitoring. We believe that there is a need for further studies focused on the use of ONSD and NIRS in the monitoring of increased ICP.

scholarly journals Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure: a systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016194 ◽  
Author(s):  
Alex Koziarz ◽  
Niv Sne ◽  
Fraser Kegel ◽  
Waleed Alhazzani ◽  
Siddharth Nath ◽  
...  
Keyword(s):  
Systematic Review ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Increased Intracranial Pressure ◽  
Nerve Sheath ◽  
Registration Number ◽  
Increased Icp

IntroductionIncreased intracranial pressure (ICP) is a significant neurological issue that may lead to permanent neurological sequelae. When evaluating patients with traumatic brain injury, it is crucial to identify those with high ICP in order to expedite ICP lowering measures and maintain adequate cerebral perfusion. Several measures are used to recognise patients with increased ICP including CT scan, MRI, ICP monitor, and lumbar puncture (LP). However, these tests can be invasive, associated with radiation exposure, contraindicated, or not readily available. Ultrasonography measurement of the optic nerve sheath diameter (ONSD) is proposed as a non-invasive and quick measure to identify high ICP. The aim of this systematic review and meta-analysis will be to examine the accuracy of ONSD sonography for increased ICP diagnosis.Methods and analysesWe will include published and unpublished randomised controlled trials, observational studies, and abstracts, with no publication type or language restrictions. Search strategies will be designed to peruse the MEDLINE, Embase, Web of Science, WHO Clinical Trials, ClinicalTrials.gov, CINAHL, and the Cochrane Library databases. We will also implement strategies to search grey literature. Two reviewers will independently complete data abstraction and conduct quality assessment. Included studies will be assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We will construct the hierarchical summary receiver operating characteristic curve for included studies and pool sensitivity and specificity using the bivariate model. We also plan to conduct prespecified subgroup analyses to explore heterogeneity. The overall quality of evidence will be rated using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).Ethics and disseminationResearch ethics board approval is not required for this study as it draws from published data and raises no concerns related to patient privacy. This review will provide a comprehensive assessment of the evidence on ONSD sonography diagnostic accuracy and is directed to a wide audience. Results from the review will be disseminated extensively through conferences and submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42017055485.Clinical trial numberTrial registration number isNCT00783809.

scholarly journals To observe the changes of optic nerve sheath diameter following the use of total intravenous anaesthesia with propofol or inhalational anaesthesia with desflurane during laparoscopic surgeries

2021 ◽  
Vol 8 (4) ◽  
pp. 515-520
Author(s):  
Pratikkumar Patel ◽  
Vijay Mathur ◽  
Shruti Singhal ◽  
Durga Jethava
Keyword(s):  
Laparoscopic Surgery ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Total Intravenous Anaesthesia ◽  
Trendelenburg Position ◽  
Intravenous Anaesthesia ◽  
Nerve Sheath ◽  
Inhalational Anaesthesia ◽  
The Mean

Optic nerve sheath diameter measurement is a simple, non-invasive and yet accurate intracranial pressure (ICP) assessment technique during laparoscopic surgery. The pneumoperitoneum induced by insufflating carbon-dioxide and steep angle of trendelenburg position is associated with physiological changes resulting in increased ICP during laparoscopic surgery. We aimed to observe the changes of ONSD (surrogate marker of ICP) following the use of total intravenous anaesthesia in comparison to desflurane during laparoscopic surgery.Patients scheduled for elective laparoscopic surgery were randomly assigned to the TIVA or DES group in this randomized study. Ultrasonographic measurements of ONSD were conducted before administration of anaesthesia (T0), 10 mins, 30 mins, 1 hr after the trendelenburg position (T1,T2,T3), 5mins after resuming the supine position (T4) and at post-anaesthetic care unit (T5). The primary outcome measure was the comparison of the mean ONSD of both the eyes of the patients of both the groups that is TIVA versus DES (inhalational anaesthetic) group.A total of 60 patients were analysed in our study. The mean ONSD value at T1, T2, T3 and T4 (for right eye p=0.002,0.001,<0.01,0.03 respectively and for left eye p=0.004,<0.01,<0.01,0.02 respectively) were significantly lower for patients in TIVA group as compared with those in DES group.Our result suggests that TIVA may be a better option than inhalational anaesthesia to prevent rise in intracranial pressure in patients undergoing laparoscopic surgery and preventing devastating complications caused by raised intracranial pressure in succeptible patients.

Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: a meta-analysis

2018 ◽  
Vol 60 (2) ◽  
pp. 221-229 ◽  
Author(s):  
Sung-Eun Kim ◽  
Eun Pyo Hong ◽  
Heung Cheol Kim ◽  
Si Un Lee ◽  
Jin Pyeong Jeon
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Summary Receiver Operating Characteristic ◽  
Nerve Sheath ◽  
Study Characteristics ◽  
Meta Regression

Background The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients. Purpose To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis. Material and Methods A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). A summary receiver operating characteristic (SROC) graph was used to provide summary points for sensitivity and specificity. Meta-regression tests were performed to estimate the influence of the study characteristics on DOR. Publication bias was assessed using Deeks' funnel plot asymmetry test. Results Six studies with 352 patients were included in the meta-analysis. US ONSD > 5.0 mm revealed pooled sensitivity of 99% (95% CI = 96–100) and specificity of 73% (95% CI = 65–80) for IICP detection. DOR was 178. The area under the SROC curve was 0.981, indicating a good level of accuracy. Meta-regression studies showed no significant associations between DOR and study characteristics such as probe mode (relative DOR [RDOR] = 0.60; P = 0.78), study quality (RDOR = 0.52; P = 0.67), IICP prevalence (RDOR = 0.04; P = 0.17), or pathology at admission (RDOR = 1.30; P = 0.87). Conclusion US ONSD > 5.0 mm can be used to rapidly detect IICP in adults in emergency departments and intensive care units. Further meta-analysis based on individual patient-level databases is needed to confirm these results.

Ultrasound Nomograms of the Fetal Optic Nerve Sheath Diameter

2018 ◽  
Vol 40 (04) ◽  
pp. 476-480 ◽  
Author(s):  
Karina Krajden Haratz ◽  
Yaakov Melcer ◽  
Zvi Leibovitz ◽  
Hagit Feit ◽  
Tally Lerman-Sagie ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Quadratic Equation ◽  
Optic Nerve Sheath ◽  
Specific Reference ◽  
Intraobserver Variability ◽  
Cross Sectional ◽  
Mean Values ◽  
Nerve Sheath ◽  
The Mean

Abstract Objective To construct prenatal age-specific reference intervals for sonographic measurements of the optic nerve sheath diameter (ONSD) during gestation in normal fetuses. Materials and Methods Prospective cross-sectional study of fetuses assessed in antenatal ultrasound units between 2010 and 2014. The examination was based on a technique for the sonographic assessment of ONSD previously published by our group. The mean values and SDs of the ONSD were modeled as a function of the gestational week by curve estimation analysis based on the highest adjusted R2 coefficient. Repeatability tests were performed to assess intraobserver variability and interobserver agreement. Results During the study period 364 healthy fetuses were enrolled. The mean values for the ONSD varied from 0.6 mm at 15–16 weeks to 2.8 mm at 37–38 weeks. The ONSD grows in a linear fashion throughout gestation, with a quadratic equation providing an optimal fit to the data (adjusted R2 = 0.957). Conclusion Sonographic age-specific references for the fetal ONSD are presented. This data may assist in the decision-making process in fetuses with a suspected increase in intracranial pressure, or anomalies affecting the development of optic stalks, such as optic hypoplasia and septo-optic dysplasia.

scholarly journals Accuracy of Noninvasive Intraocular Pressure or Optic Nerve Sheath Diameter Measurements for Predicting Elevated Intracranial Pressure in Cryptococcal Meningitis

2014 ◽  
Vol 1 (3) ◽  
Author(s):  
Henry W. Nabeta ◽  
Nathan C. Bahr ◽  
Joshua Rhein ◽  
Nicholas Fossland ◽  
Agnes N. Kiragga ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Cryptococcal Meningitis ◽  
Optic Nerve Sheath Diameter ◽  
Diagnostic Value ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Nerve Sheath ◽  
Immunodeficiency Virus

Abstract Background.  Cryptococcal meningitis is associated with increased intracranial pressure (ICP). Therapeutic lumbar puncture (LP) is recommended when the initial ICP is >250 mm H2O, yet the availability of manometers in Africa is limited and not always used where available. We assessed whether intraocular pressure could be a noninvasive surrogate predictor to determine when additional therapeutic LPs are necessary. Methods.  Ninety-eight human immunodeficiency virus-infected Ugandans with suspected meningitis (81% Cryptococcus) had intraocular pressure measured using a handheld tonometer (n = 78) or optic nerve sheath diameter (ONSD) measured by ultrasound (n = 81). We determined the diagnostic performance of these methods for predicting ICP vs a standard manometer. Results.  The median ICP was 225 mm H2O (interquartile range [IQR], 135–405 mm H2O). The median intraocular pressure was 28 mm Hg (IQR, 22–37 mm Hg), and median ultrasound ONSD was 5.4 mm (IQR, 4.95–6.1 mm). ICP moderately correlated with intraocular pressure (ρ = 0.45, P < .001) and with ultrasound ONSD (ρ = 0.44, P < .001). There were not discrete threshold cutoff values for either tonometry or ultrasound ONSD that provided a suitable cutoff diagnostic value to predict elevated ICP (>200 mm H2O). However, risk of elevated ICP >200 mm H2O was increased with an average intraocular pressure >28 mm Hg (relative risk [RR] = 3.03; 95% confidence interval [CI], 1.55–5.92; P < .001) or an average of ONSD >5 mm (RR = 2.39; 95% CI, 1.42–4.03; P = .003). As either intraocular pressure or ONSD increased, probability of elevated ICP increased (ie, positive predictive value increased). Conclusions.  Noninvasive intraocular pressure measurements by tonometry or ultrasound correlate with cerebrospinal fluid opening pressure, but both are a suboptimal replacement for actual ICP measurement with a manometer.

Sign in / Sign up

Export Citation Format

Share Document