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Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury.
Intensive Care Med 2007; 33(10):1704-11IC

Abstract

OBJECTIVE

To assess at admission to the ICU the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) and to investigate whether increased ONSD at patient admission is associated with raised ICP in the first 48[Symbol: see text]h after trauma.

DESIGN AND SETTING

Prospective, blind, observational study in a surgical critical care unit, level 1 trauma center.

PATIENTS AND PARTICIPANTS

31 adult patients with severe traumatic brain injury (TBI; Glasgow coma scale <or=8) requiring sedation and ICP monitoring, and 31 control patients without brain injury requiring sedation.

MEASUREMENTS AND RESULTS

ONSD was measured with a 7.5-MHz linear ultrasound probe. Two TBI groups were defined on the basis of ICP profile. If ICP exceeded 20 mmHg for more than 30 min in the first 48 h (before any specific treatment), patients were considered to have high ICP; if not, they had normal ICP. The largest ONSD value (the highest value for the right and left eye) was significantly higher in high ICP patients (6.3 +/-0.6 vs. 5.1+/-0.7 mm in normal ICP patients and 4.9+/-0.3mm in control patients). There was a significant relationship between the largest ONSD and ICP at admission (r=0.68). The largest ONSD was a suitable predictor of high ICP (area under ROC curve 0.96). When ONSD was under 5.7 mm, the sensitivity and negative predictive values for high ICP were 100%.

CONCLUSIONS

In the early posttraumatic period, ocular ultrasound scans may be useful for detecting high ICP after severe TBI.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care Medicine, Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Faculty of Medicine, University of Paris-Sud, Le Kremlin Bicêtre, 94275, Paris, France. thomas.geeraerts@bct.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17668184

Citation

Geeraerts, Thomas, et al. "Ultrasonography of the Optic Nerve Sheath May Be Useful for Detecting Raised Intracranial Pressure After Severe Brain Injury." Intensive Care Medicine, vol. 33, no. 10, 2007, pp. 1704-11.
Geeraerts T, Launey Y, Martin L, et al. Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med. 2007;33(10):1704-11.
Geeraerts, T., Launey, Y., Martin, L., Pottecher, J., Vigué, B., Duranteau, J., & Benhamou, D. (2007). Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Medicine, 33(10), pp. 1704-11.
Geeraerts T, et al. Ultrasonography of the Optic Nerve Sheath May Be Useful for Detecting Raised Intracranial Pressure After Severe Brain Injury. Intensive Care Med. 2007;33(10):1704-11. PubMed PMID: 17668184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. AU - Geeraerts,Thomas, AU - Launey,Yoann, AU - Martin,Laurent, AU - Pottecher,Julien, AU - Vigué,Bernard, AU - Duranteau,Jacques, AU - Benhamou,Dan, Y1 - 2007/08/01/ PY - 2007/01/03/received PY - 2007/06/18/accepted PY - 2007/8/2/pubmed PY - 2008/6/19/medline PY - 2007/8/2/entrez SP - 1704 EP - 11 JF - Intensive care medicine JO - Intensive Care Med VL - 33 IS - 10 N2 - OBJECTIVE: To assess at admission to the ICU the relationship between optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) and to investigate whether increased ONSD at patient admission is associated with raised ICP in the first 48[Symbol: see text]h after trauma. DESIGN AND SETTING: Prospective, blind, observational study in a surgical critical care unit, level 1 trauma center. PATIENTS AND PARTICIPANTS: 31 adult patients with severe traumatic brain injury (TBI; Glasgow coma scale <or=8) requiring sedation and ICP monitoring, and 31 control patients without brain injury requiring sedation. MEASUREMENTS AND RESULTS: ONSD was measured with a 7.5-MHz linear ultrasound probe. Two TBI groups were defined on the basis of ICP profile. If ICP exceeded 20 mmHg for more than 30 min in the first 48 h (before any specific treatment), patients were considered to have high ICP; if not, they had normal ICP. The largest ONSD value (the highest value for the right and left eye) was significantly higher in high ICP patients (6.3 +/-0.6 vs. 5.1+/-0.7 mm in normal ICP patients and 4.9+/-0.3mm in control patients). There was a significant relationship between the largest ONSD and ICP at admission (r=0.68). The largest ONSD was a suitable predictor of high ICP (area under ROC curve 0.96). When ONSD was under 5.7 mm, the sensitivity and negative predictive values for high ICP were 100%. CONCLUSIONS: In the early posttraumatic period, ocular ultrasound scans may be useful for detecting high ICP after severe TBI. SN - 0342-4642 UR - https://www.unboundmedicine.com/medline/citation/17668184/Ultrasonography_of_the_optic_nerve_sheath_may_be_useful_for_detecting_raised_intracranial_pressure_after_severe_brain_injury_ L2 - https://dx.doi.org/10.1007/s00134-007-0797-6 DB - PRIME DP - Unbound Medicine ER -