Comparison of ultrasonographic versus infrared pupillary assessment

Yic, Christian Daniel; Prada, Gabriel; Paz, Sergio I.; Moraes, Leandro; Pontet, Julio; Lasso, Marcos E.; Biestro, Alberto

doi:10.1186/s13089-020-00188-1

Cited by 8 publications

(3 citation statements)

References 21 publications

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“…B-mode ultrasound an objective method for the quantitative assessment of pupillary function, which is useful where eyelid retraction is impeded or a pupillometry device is unavailable [73]. Ultrasonography pupillary assessment has high Pearson's correlation coefficient (r) with infrared pupillometer (r = 0.92 right eye and r = 0.96 left eye) in critically ill patients [84] (Fig. • Mode:…”

Section: • Modementioning

confidence: 99%

Neurosurgical Patient in ICU: Usefulness of Transcranial Doppler (TCD/TCCS) in Postoperative Monitoring

Rodríguez

Geeraerts

2021

Neurosonology in Critical Care

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The basic principle of neurosurgical patient management is to ensure adequate brain tissue perfusion, maintaining a sufficient blood flow to supply energy and oxygen to the brain parenchyma. 2. If neuroworsening occurs after a neurosurgical procedure, prompt recognition is essential because it may be the first indication of potential complications. 3. In many clinical scenarios during neurosurgical postoperative period, TCD/ TCCS may have a transcendent role in diminished gap between neurological clinical examination and other investigations that may be invasive or require patient transport outside of the ICU. 4. Midline shift (MLS) monitoring is important for preventing neurological worsening and assess early neurosurgical intervention. Keep in mind that any amount of midline shift is considered abnormal. 5. Measurement of volume of Intracerebral Hematoma (ICH) is a very useful monitoring tool in the daily bedside following, and thus contribute to therapeutic decisions in real time interpreting the clinical trends. 6. The most used approach, to diagnose hydrocephalus by TCCS, is the measurement of the diameter of the third ventricle through the transtemporal window. 7. It is critical to interpret and integrate hemodynamic qualitative and quantitative trends (not only the absolute value) of the Spectral Doppler wave (blood flow velocity patterns) with the clinical context of the patient.

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Section: • Modementioning

confidence: 99%

Neurosurgical Patient in ICU: Usefulness of Transcranial Doppler (TCD/TCCS) in Postoperative Monitoring

Rodríguez

Geeraerts

2021

Neurosonology in Critical Care

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“…Also, USG method is compared with the infrared pupilometer (gold standard method) in one of the recent studies that has already established good agreement between the two. 10 The primary objective was to determine the extent of agreement between clinical examination and ultrasound-based examination for assessing pupillary reflex and size in patients with altered mental status in two settings (trauma and non-trauma patients).…”

mentioning

confidence: 99%

“…Since clinical examination is being used since a long time for pupillary examination in emergency settings and resource‐limited settings, we studied the agreement of pupillary size between clinical and USG methods of pupillary light reflex (PLR) examination. Also, USG method is compared with the infrared pupilometer (gold standard method) in one of the recent studies that has already established good agreement between the two 10 …”

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confidence: 99%

Feasibility of USG‐Guided Objective Initial Assessment of Pupillary Size and Pupillary Reflexes Versus Clinical Examination in Patients With Altered Mental Status

Modi,

Bhoi,

Aggarwal

et al. 2023

J of Ultrasound Medicine

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BackgroundPupillary assessment is an important part of the neurological assessment which provides vital information in critically ill patients. However, clinical pupillary assessment is subjective. The ultrasound‐guided pupillary examination is objective. There are limited pieces of literature regarding its use in assessing patients with altered mental status. So, we studied the extent of agreement of B‐mode ultrasound with clinical examination for assessment of the pupillary size and reflex in patients with altered mental status.ObjectivesThe primary objective was to determine the extent of agreement between clinical examination and ultrasound‐based examination for assessing pupillary reflex and size in patients with altered mental status in two settings (trauma and non‐trauma patients).MethodsExactly 200 subjects (158 males, mean [range] age 43.56 [18–92 years]) with no history of partial globe rupture or dementia were included in this cross‐sectional study from March 2019 to March 2020. B‐mode ultrasound was performed with the subject's eyes closed using a 7–12 MHz linear probe and a standardized light stimulus. ICC score, paired t‐test, kappa, Wilcoxon signed‐rank test, and Bland–Altman plots were used for statistical analysis.ResultsThe clinical‐USG agreement for pupillary light reflex examination (Pupillary Diameter [PD] at rest, after direct light stimulation [Dstim] and consensual light stimulation [Cstim]) was excellent (ICC, 0.93–0.96). The Kappa coefficient (0.74 ± 0.07) showed an agreement of 87.36% between clinical and USG examination for pupillary reflex (reactive or non‐reactive).ConclusionUSG‐guided pupillary examination proves to be a better adjunct to neurological assessment in patients with altered mental status.

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Role of Brain Ultrasound for the Assessment of Intracranial Hypertension

Puppo

2023

Lessons From the ICU

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Comparison of ultrasonographic versus infrared pupillary assessment

Abstract: Objectives: To evaluate the correlation between ultrasonographic and infrared pupillary assessments in critically ill patients, including neurocritically ill patients.

Cited by 8 publications

References 21 publications

Neurosurgical Patient in ICU: Usefulness of Transcranial Doppler (TCD/TCCS) in Postoperative Monitoring

Neurosurgical Patient in ICU: Usefulness of Transcranial Doppler (TCD/TCCS) in Postoperative Monitoring

Feasibility of USG‐Guided Objective Initial Assessment of Pupillary Size and Pupillary Reflexes Versus Clinical Examination in Patients With Altered Mental Status

Role of Brain Ultrasound for the Assessment of Intracranial Hypertension

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