Optic nerve sheath diameter ultrasound measurement to evaluate cerebral edema in children with diabetic ketoacidosis

2019 ◽  
Vol 32 (11) ◽  
pp. 1205-1206
Author(s):  
Maddalena De Bernardo ◽  
Livio Vitiello ◽  
Nicola Rosa
Keyword(s):  
Optic Nerve ◽  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Nerve Sheath

Determination of cerebral edema with serial measurement of optic nerve sheath diameter during treatment in children with diabetic ketoacidosis: a longitudinal study

2019 ◽  
Vol 32 (9) ◽  
pp. 943-949 ◽  
Author(s):  
Ozlem Tolu Kendir ◽  
Hayri Levent Yilmaz ◽  
Ahmet Kagan Ozkaya ◽  
Ihsan Turan ◽  
Sinem Sari Gokay ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Clinical Signs ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Serial Measurement ◽  
Eyes Closed ◽  
Nerve Sheath ◽  
Linear Probe

Abstract Background Cerebral edema is a fatal complication that can occur in children with diabetic ketoacidosis (DKA). Its clinical signs are generally not explicit, and subclinical cerebral edema can occur. This study is one of the few longitudinal studies conducted to identify cerebral edema in patients with DKA by measuring the optic nerve sheath diameter (ONSD). The aim of this study was to investigate cerebral edema in children with DKA with serial measurement of ONSD, which is an early and reliable indicator of cerebral edema, and to monitor changes in ONSD during therapy. Methods The study was conducted by measuring ONSD ultrasonographically at baseline and during the course of therapy in patients with DKA. All participants were diagnosed and received therapy at our unit between May 2016 and June 2017. The study was registered with the Clinical Trials database, with a study number of NCT02937441. Measurements were obtained while the patients were in the supine position with their eyes closed, and axial transbulbar images of both eyes were obtained with a 6–15-MHz linear probe. Results The ONSD values of children with DKA changed during the treatment, reaching the highest values at 12–16 h of therapy, and the greatest ONSD was observed in children who had moderate and severe DKA. Conclusions During treatment of children with DKA, it is possible to predict cerebral edema by measuring ONSD, and this may contribute to clinical management, especially fluid treatment.

scholarly journals A unique method for estimating the reliability learning curve of optic nerve sheath diameter ultrasound measurement

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Frederick A. Zeiler ◽  
Markus T. Ziesmann ◽  
Patrick Goeres ◽  
Bertram Unger ◽  
Jason Park ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Learning Curve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Nerve Sheath ◽  
Unique Method

scholarly journals How accurate is ultrasound of the optic nerve sheath diameter performed by inexperienced operators to exclude raised intracranial pressure?

2015 ◽  
Vol 19 (1) ◽  
Author(s):  
G. J. Du Toit ◽  
D. Hurter ◽  
M. Nel
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Lumbar Puncture ◽  
Predictive Value ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Raised Intracranial Pressure ◽  
Cross Sectional ◽  
Nerve Sheath

Background: It has been well documented that ultrasound measurement of the optic nerve sheath diameter performed by an experienced operator shows good correlation with raised intracranial pressure, irrespective of the cause. Objective: To establish the accuracy of this technique performed by inexperienced operators.Method: A prospective analytical cross-sectional study was conducted. All patients ≥18 years of age who presented at our medical casualty and emergency departments with suspected meningitis were enrolled in the study. All patients were evaluated with the use of optic nerve sheath diameter ultrasound with or without computed tomography brain scan prior to lumbar puncture. Lumbar puncture opening pressure measurements were compared with the ultrasound measurements.Results: A total of 73 patients were enrolled in the study, of whom 14 had raised intracranial pressure. The study had a sensitivity of 50% (95% confidence interval (CI) 26.8%–73.2%) and specificity of 89.8% (95% CI 79.5%–95.3%) with a positive predictive value of 54.8% (95% CI 29.1%–76.8%) and negative predictive value of 88.3% (95% CI 77.8%–94.2%). The likelihood ratio of a positive test was 4.92 (95% CI 1.95–11.89) and that of a negative test 0.56 (95% CI 0.29–0.83). Cohen’s kappa value was 0.41 which indicates a moderate agreement. The receiver operating characteristic (ROC) curve had an area under the curve (AUC) of 0.73 (95% CI 0.51–0.95). Conclusion: Ultrasound measurement of the optic nerve sheath diameter can be used to exclude raised intracranial pressure, even in the hands of inexperienced operators.

scholarly journals Optic nerve sheath diameter by bedside ultrasound is a reliable screening test for cerebral edema in the comatose ICU patient

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P457 ◽  
Author(s):  
A Mohamed ◽  
N Alharbi ◽  
N Salahuddin ◽  
I Hussain ◽  
O Solaiman
Keyword(s):  
Optic Nerve ◽  
Cerebral Edema ◽  
Screening Test ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Bedside Ultrasound ◽  
Nerve Sheath

The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children

2016 ◽  
Vol 32 (10) ◽  
pp. 1769-1778 ◽  
Author(s):  
Llewellyn C. Padayachy ◽  
Vaishali Padayachy ◽  
Ushma Galal ◽  
Rebecca Gray ◽  
A. Graham Fieggen
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Nerve Sheath ◽  
The Relationship

Optic Nerve Sheath Diameter Ultrasonography in Pediatric Patients with Diabetic Ketoacidosis

2016 ◽  
Vol 40 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Gregory Hansen ◽  
Elizabeth A.C. Sellers ◽  
Darcy L. Beer ◽  
Jeff K. Vallance ◽  
Ian Clark
Keyword(s):  
Optic Nerve ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath

The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children.

2016 ◽  
Vol 32 (10) ◽  
pp. 1779-1785 ◽  
Author(s):  
Llewellyn C. Padayachy ◽  
Vaishali Padayachy ◽  
Ushma Galal ◽  
Travis Pollock ◽  
A. Graham Fieggen
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Ultrasound Measurement ◽  
Nerve Sheath ◽  
The Relationship
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