Prediction of Intracranial Pressure in Patients with an Aneurysmal Subarachnoid Hemorrhage Using Optic Nerve Sheath Diameter via Explainable Predictive Modeling

Kim, Kwang Hyeon; Kang, Hyung Koo; Koo, Hae-Won

doi:10.3390/jcm13072107

Cited by 3 publications

References 45 publications

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Effects of Different Ventilation Modes on Intracranial Pressure and Carbon Dioxide Partial Pressure during Bariatric Surgery: a Prospective, Randomized, Controlled Study

Jia,

Chen,

Zhang

et al. 2024

Preprint

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Background Obesity is linked to the retention of carbon dioxide, headaches, and idiopathic intracranial hypertension. Although studies indicate that different ventilation modalities may change intracranial pressure and carbon dioxide partial pressure, their impact on bariatric surgery patients remains unclear. This study aimed to monitor, compare, and analyze respiratory mechanics, carbon dioxide partial pressure, and intracranial pressure under three ventilation modes: pressure control (PC), volume control (VC), and pressure-regulated volume control (PRVC) during bariatric surgery to explore the clinical significance and value of the PRVC ventilation mode. Methods This was a prospective, randomized, controlled clinical study. Ninety patients who underwent bariatric surgery were randomly randomized into three groups: Group I utilized pressure control ventilation (PC), Group II used volume control ventilation (VC), and Group III utilized pressure-regulated volume control ventilation (PRVC). Measurements were obtained at five time points: before pneumoperitoneum (T1), 5 minutes after pneumoperitoneum (T2), 10 minutes after pneumoperitoneum (T3), 15 minutes after pneumoperitoneum (T4), and 20 minutes after pneumoperitoneum (T5). The collected parameters included: intracranial pressure (ICP, measured through the optic nerve sheath diameter [ONSD]), esophageal pressure (PES), average airway pressure (PAWM), peak airway pressure (PAP), arterial carbon dioxide partial pressure (PaCO2), end-tidal carbon dioxide concentration or partial pressure (ETCO2), tidal volume (TV), mean arterial pressure (MAP, calculated as MAP = diastolic pressure + 1/3 pulse pressure difference), and heart rate (HR). Results In all three breathing modes, pneumoperitoneum induced various degrees of increase in the ONSD, PAWM, PAP, and PES. There were no significant differences in PAWM among the groups at any time point (P > 0.05). However, the PES was much higher in the VC mode following pneumoperitoneum than in the PC and PRVC modes. Compared to the other two groups, the TV was considerably lower in the PC group following pneumoperitoneum (P < 0.05). PaCO2 and ETCO2 increased in the PC and VC groups following pneumoperitoneum, resulting in significant increases in ONSD, MAP, and HR (P < 0.05), but the PRVC group showed no significant changes in ONSD, MAP, and HR (P > 0.05). Conclusion The results of this study demonstrate that the PRVC mode can successfully prevent increases in ICP, PAWM, PAP, and PES caused by pneumoperitoneum. It also prevents abnormal TV fluctuations during surgery, ensuring the stability of the patient's vital signs during the perioperative period. Therefore, the PRVC mode is the ideal ventilation mode for laparoscopic bariatric surgery. Additionally, ONSD ultrasound assessment, a noninvasive method for evaluating the ICP, can be safely employed during laparoscopic bariatric surgery.

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Effects of Different Ventilation Modes on Intracranial Pressure and Carbon Dioxide Partial Pressure during Bariatric Surgery: a Prospective, Randomized, Controlled Study

Jia,

Chen,

Zhang

et al. 2024

Preprint

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Emerging Applications of Image Post-Processing 3D Visualisation for Cerebrovascular Diseases

Dong,

Zhou,

Jian

et al. 2024

J. Integr. Neurosci.

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Intracranial vascular-related diseases are a common occurrence in neurosurgery. They have complex and diverse pathogeneses; further, their diagnosis and treatment remain unclear. Three-dimensional image post-processing technology is an emerging technology that involves converting a brain image scan into a digital model using image post-processing software, thus establishing a 3D view of the region of interest. Three-dimensional visualisation of the brains of patients with cerebrovascular diseases can allow a more intuitive examination of the local anatomy of the lesion as well as the adjacency between the lesion and peripheral nerves, brain tissue, and skull bones. Subsequently, this informs pre-operative planning, allows more accurate diagnosis of cerebrovascular diseases, and improves the safety of surgical treatment. This review summarised the current literature regarding cerebrovascular diseases and the application of 3D image post-processing technology in different cerebrovascular diseases.

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Optic nerve sheath diameters in nontraumatic brain injury: A scoping review and role in the intensive care unit

Bhide,

Juneja,

Singh

et al. 2024

World J Crit Care Med

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BACKGROUND Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure (ICP) modalities or unstable to transport for imaging. Ultrasonography-based optic nerve sheath diameter (ONSD) is an attractive option as it is reliable, repeatable and easily performed at the bedside. It has been sufficiently validated in traumatic brain injury (TBI) to be incorporated into the guidelines. However, currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made. AIM To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients. METHODS PubMed, Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP. Studies from 2010 to 2024 in English languages were included. RESULTS We found 37 articles relevant to our search. The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm. Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter. ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke, intracerebral bleeding and intracranial infection. However, ONSD is of doubtful utility in septic metabolic encephalopathy, dysnatremias and aneurysmal subarachnoid haemorrhage. CONCLUSION ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.

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Prediction of Intracranial Pressure in Patients with an Aneurysmal Subarachnoid Hemorrhage Using Optic Nerve Sheath Diameter via Explainable Predictive Modeling

Cited by 3 publications

References 45 publications

Effects of Different Ventilation Modes on Intracranial Pressure and Carbon Dioxide Partial Pressure during Bariatric Surgery: a Prospective, Randomized, Controlled Study

Effects of Different Ventilation Modes on Intracranial Pressure and Carbon Dioxide Partial Pressure during Bariatric Surgery: a Prospective, Randomized, Controlled Study

Emerging Applications of Image Post-Processing 3D Visualisation for Cerebrovascular Diseases

Optic nerve sheath diameters in nontraumatic brain injury: A scoping review and role in the intensive care unit

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