The Effect of Continuous Epidural Analgesia on Intracranial Pressure by Measuring the Optic Nerve Sheath Diameter Using Ultrasound in Pediatric Patients

2019 ◽  
Author(s):  
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Epidural Analgesia ◽  
Pediatric Patients ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Continuous Epidural Analgesia

scholarly journals Optic nerve sheath diameter measurement for predicting raised intracranial pressure in pediatric patients: A systematic review and meta-analysis

2019 ◽  
pp. 102490791989277
Author(s):  
Sun Hwa Lee ◽  
Seong Jong Yun ◽  
Dong Hyeon Kim
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Confidence Interval ◽  
Pediatric Patients ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Raised Intracranial Pressure ◽  
Brain Computed Tomography ◽  
Nerve Sheath ◽  
Ocular Ultrasound

Background and objectives: No previous studies have investigated the relationship between the optic nerve sheath diameter and raised intracranial pressure in pediatric patients or have evaluated the usefulness of optic nerve sheath diameter in ocular ultrasound and brain computed tomography/magnetic resonance imaging. This study aimed to meta-analyze the diagnostic performance of optic nerve sheath diameter for the diagnosis of raised intracranial pressure in pediatric patients. Methods: A database search of PubMed and EMBASE was performed to identify relevant studies. Bivariate modeling and hierarchical summary receiver operating characteristics modeling were performed to evaluate diagnostic performance. A pooled diagnostic odds ratio with a 95% confidence interval, not including 1, was considered informative. Subgroup analysis was performed according to the modality (ocular ultrasound vs brain computed tomography/magnetic resonance imaging). We performed meta-regression analyses for heterogeneity exploration. Results: Eleven studies involving 546 patients were included. According to pooled diagnostic odds ratios, optic nerve sheath diameter was informative for the evaluation of raised intracranial pressure (diagnostic odds ratio, 47; 95% confidence interval, 11–206). Optic nerve sheath diameter showed a pooled sensitivity of 0.88 (95% confidence interval, 0.79–0.94), a pooled specificity of 0.86 (95% confidence interval, 0.70–0.95), and an area under the hierarchical summary receiver operating characteristics curve of 0.93 (95% confidence interval, 0.91–0.95) for the diagnosis of raised intracranial pressure. According to the subgroup analysis, ocular ultrasound (sensitivity, 0.91 (95% confidence interval, 0.81–0.96); specificity, 0.86 (95% confidence interval, 0.65–0.96)) showed higher sensitivity and comparable specificity than optic nerve sheath diameter measured on brain computed tomography/magnetic resonance imaging (sensitivity, 0.75 (95% confidence interval, 0.51–0.99); specificity, 0.91 (95% confidence interval, 0.74–1.00)). On meta-regression analysis, the study design, number of patients, and reference standard were the sources of heterogeneity. Conclusion: Optic nerve sheath diameter may be a useful method for predicting raised intracranial pressure in pediatric patients. We recommend that the measurement of optic nerve sheath diameter should be performed using ocular ultrasound for a more accurate diagnosis of raised intracranial pressure in pediatric patients.

scholarly journals Optic Nerve Sheath Diameter Correlation with Elevated Intracranial Pressure Determined via Ultrasound

Cureus ◽  
2019 ◽  
Author(s):  
Kamran Munawar ◽  
Muhammad Tariq Khan ◽  
Syed Waqar Hussain ◽  
Aayesha Qadeer ◽  
Zahid Siddique Shad ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Nerve Sheath

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.

Sign in / Sign up

Export Citation Format

Share Document