scholarly journals Effect of bronchoscopy on intracranial hypertension during different regimen of sedation by optic nerve sheath diameter

2021 ◽  
Vol 26 (4) ◽  
pp. 795-800
Author(s):  
Emine Ozsari ◽  
Abdullah Demirhan
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Deep Sedation ◽  
Randomized Study ◽  
Fiberoptic Bronchoscopy ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
The Mean ◽  
Sedation Group

Objectives: Fiberoptic bronchoscopy (FOB) is a useful method for ventilator-associated pneumonia (VAP), aspiration, and atelectasis, especially in intensive care units. (ICU) We aimed to investigate the effect of FOB on intracranial pressure by ultrasonographic optic nerve sheath diameter (uONSD) during different sedation protocols in a tertiary ICU. Methods: Prospective randomized study included the patients with two groups as superficial (Group M; midazolam) and deep sedation (Group P; propofol). FOB was performed for VAP or aspiration and intracranial hypertension (ICH) was measured with uONSD, noninvasively. The values of uONSD were noted pre-procedure, on sedation, 1st – 5th, and 15th minute of the procedure. In addition, mean arterial pressures (MAP), oxygen saturation, and heart rate values were recorded from the monitor. Results: The mean age and indications of FOB for 33 patients as Group M (n=17) and Group P (n=16) were similar to each other. ONSD was increased with the procedure in both groups but in group P it was stabilized from the 5th minutes of FOB whereas became higher progressively in group M (p<0,001). Postoperative MAP values that may have an important role for ICH were also increased in Group M (MAP was 70.65 ± 16.18 at time of sedation in Group P and 75.63 ± 13.76 in Group M). Conclusion: This study showed that bronchoscopy results as a significant increase for OSND in both groups but that was less high in patients who had deep sedation with propofol and it returned to baseline after the procedure.

Repeatability of ultrasound examination of the optic nerve sheath diameter in the adult cat: comparison between healthy cats and cats suffering from presumed intracranial hypertension

2020 ◽  
Vol 22 (10) ◽  
pp. 959-965 ◽  
Author(s):  
Maria Antonietta Evangelisti ◽  
Giovanni Carta ◽  
Giovanni P Burrai ◽  
Maria Luisa Pinna Parpaglia ◽  
Francesca Cubeddu ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Linear Regression Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Right

Objectives The objectives of this study were to test: (1) the repeatability of ultrasonographic examination of the optic nerve sheath diameter (ONSD) in the cat; (2) the association between the ONSD and age, sex and body weight in healthy cats; and (3) the difference in the ONSD between healthy cats and those suffering from presumed intracranial hypertension (ICH). Methods This study had a prospective, blinded, observational cross-sectional study design. Two groups of animals were considered: healthy cats (group A) and cats with a diagnosis of presumed ICH (group B). The ONSD was evaluated, measured and compared between the two groups via an ultrasonographic transpalpebral approach. Repeatability of the procedure was evaluated through the intraclass correlation coefficient (ICC). Data were statistically compared using the Student’s t-test and linear regression analysis. Results A strong inter- and intraobserver ICC indicating good repeatability was observed. The interobserver ICC was 0.965 ( P  <0.05) for the right eye and 0.956 ( P  <0.05) for the left eye. The intraobserver ICC was 0.988 ( P  <0.05) and 0.984 ( P  <0.05) for the right and left eyes, respectively. In healthy cats the mean ± SD ONSD was 1.23 ± 0.11 mm (range 1–1.47 mm) and 1.23 ± 0.10 (range 1–1.4 mm) for right and left eyes, respectively. The ONSD was not related to sex or weight; a weak relationship was observed with age. In group B, the mean ONSD was 1.68 ± 0.13 mm (range 1.5–1.9 mm) and 1.61 ± 0.15 mm (range 1.4–1.9 mm) for the right and left eyes, respectively. In group B, the ONSD was statistically significantly larger than in group A, the healthy cats ( P  <0.001). Conclusions and relevance The transpalpebral ultrasonographic technique is a non-invasive, feasible and reproducible method to measure ONSD both in healthy cats and in cats suffering from suspected ICH.

Are ultrasonography measurements of optic nerve sheath diameter an alternative to funduscopy in children with syndromic craniosynostosis?

2011 ◽  
Vol 8 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Caroline Driessen ◽  
Natalja Bannink ◽  
Maarten Lequin ◽  
Marie-Lise C. van Veelen ◽  
Nicole C. Naus ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Predictive Values ◽  
Syndromic Craniosynostosis ◽  
Nerve Sheath ◽  
Age Related ◽  
The Mean ◽  
A Prospective Study ◽  
Ct Measurement

Object Children with syndromic or complex craniosynostosis are evaluated for increased intracranial pressure (ICP) using funduscopy to detect papilledema. However, papilledema is a late sign of increased ICP. Because papilledema might be preceded by an increase in optic nerve sheath (ONS) diameter, the authors conducted a prospective study to establish the validity and applicability of measuring the ONS using ultrasonography. Methods From January 2007 to December 2009, 175 bilateral ultrasonography ONS measurements were performed in 128 patients with syndromic or complex craniosynostosis during the daytime. The measurements were correlated with ONS diameter assessed on CT and simultaneous funduscopy, when available. Furthermore, results were compared by using thresholds for ONS diameters on ultrasonography that are available in the literature. Results The mean ONS diameter on ultrasonography was 3.1 ± 0.5 mm. The CT measurement was significantly correlated with the ultrasonography measurement (r = 0.41, p < 0.001). The mean ONS diameter in 38 eyes with papilledema was 3.3 ± 0.5 mm, compared with 3.1 ± 0.5 mm in the eyes of patients without papilledema (p = 0.039). Relative to the age-related thresholds, the ONS diameter was too large in 11 eyes (3%), particularly in patients with Crouzon syndrome. Compared with funduscopy, ultrasonography sensitivity was 11%, specificity was 97%, and positive and negative predictive values were 40% and 86%, respectively. Conclusions Ultrasonography is a valid and easy way of quantifying the ONS. Although the ONS diameter is larger in children with papilledema, it cannot be used as a daytime screening tool instead of funduscopy. The ONS diameter is possibly a more real-time indicator of ICP.

Optic nerve sheath diameter ultrasonography at admission as a predictor of intracranial hypertension in traumatic brain injured patients: a prospective observational study

2020 ◽  
Vol 132 (4) ◽  
pp. 1279-1285 ◽  
Author(s):  
Chiara Robba ◽  
Joseph Donnelly ◽  
Danilo Cardim ◽  
Tamara Tajsic ◽  
Manuel Cabeleira ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Reactivity Index ◽  
Nerve Sheath ◽  
Secondary Injuries ◽  
Patients At Risk ◽  
Severe Tbi ◽  
Injured Patients

OBJECTIVEIntracranial hypertension and impaired cerebral autoregulation are common causes of secondary injuries in patients with traumatic brain injury (TBI). The primary outcome of this study was to assess whether a noninvasive method to estimate intracranial pressure (ICP) based on the ultrasonography of the optic nerve sheath diameter (ONSD) measured at the time of neurocritical care unit (NCCU) admission is correlated with the mean ICP during NCCU stay. Secondary outcomes were to assess whether ONSD is correlated with the dose of ICP > 20 mm Hg and impaired autoregulation during NCCU stay and with instantaneous ICP and whether ONSD is associated with NCCU mortality.METHODSThis prospective observational monocentric study included adults with severe TBI. ONSD was measured at NCCU admission, immediately after invasive ICP insertion. ONSD-predicted noninvasive ICP (nICPONSD) was calculated according the formula: nICPONSD= 5 × ONSD − 14 (nICPONSDin mm Hg, ONSD in mm). Autoregulation was measured using the pressure reactivity index (PRx).RESULTSIn total, 100 patients were included in this study. ONSD was significantly correlated with mean ICP (r = 0.46, p < 0.0001), with mean PRx (r = 0.21, p = 0.04), and with the dose of ICP > 20 mm Hg during NCCU stay (r = 0.49, p < 0.0001). Admission nICPONSDwas shown to be significantly correlated with instantaneous ICP (r = 0.85, p < 0.001). ONSD at admission was significantly correlated with NCCU mortality (p = 0.02).CONCLUSIONSONSD measured at NCCU admission can give important information about patients at risk of developing intracranial hypertension and impaired autoregulation. ONSD examination could be useful to screen patients at admission to determine who would benefit from further invasive ICP monitoring.

scholarly journals MRI of the optic nerve sheath and globe in cats with and without presumed intracranial hypertension

2020 ◽  
pp. 1098612X2097610
Author(s):  
Joanna Lodzinska ◽  
Elizabeth Munro ◽  
Darren J Shaw ◽  
Anna Suñol
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Transverse Diameter ◽  
Mri Findings ◽  
Good Reliability ◽  
Nerve Sheath

Objectives The study aimed to: (1) test MRI repeatability of measurements of optic nerve sheath diameter (ONSD), optic nerve diameter (OND) and eye globe transverse diameter (ETD); (2) investigate the associations between the OND, ONSD and ETD; (3) assess whether these measurements are affected by age or body weight; and (4) test the association between ONSD, OND, ETD and ONSD: ETD ratio with presumed intracranial pressure (ICP) status. Methods This was a retrospective and blinded study where patients were allocated to presumed normal or intracranial hypertension groups based on MRI findings. The ONSD and ETD were measured and recorded. Interclass correlation coefficient (ICC) was calculated to investigate interobserver agreement. Data were analysed using the Pearson correlation coefficient, two-sample t-test and general linear model ANOVA. Results: Seventy-seven cats were included, 62 with presumed normal ICP and 15 with presumed intracranial hypertension. The ICC showed moderate-to-good reliability for all measurements. Positive correlations were identified for: (1) ETD and weight; (2) ONSD and age; (3) OND and age; (4) ONSD and ETD; (5) ONSD: ETD ratio and presumed ICP status; and (6) ONSD and presumed ICP status. No difference was detected between the presumed normal and intracranial hypertension groups and ONSD, as well as ONSD: ETD ratio and presumed ICP status when patient age was considered. Conclusions and relevance The measurement of the ONSD and the ONSD: ETD ratio on T2-weighted MRI might not be reliable as non-invasive tests for diagnosing intracranial hypertension in cats.

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.

Sonographic assessment of the optic nerve sheath diameter in the diagnosis of idiopathic intracranial hypertension

2016 ◽  
Vol 361 ◽  
pp. 122-127 ◽  
Author(s):  
Pablo del Saz-Saucedo ◽  
Olga Redondo-González ◽  
Ángel Mateu-Mateu ◽  
Rafael Huertas-Arroyo ◽  
Rafael García-Ruiz ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Nerve Sheath ◽  
Sonographic Assessment
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