Real-time evaluation of optic nerve sheath diameter (ONSD) in awake neurosurgical patients

Weidner, N.; Bomberg, Hagen; Antes, Sebastian; Meiser, Andreas; Volk, Th.; Groesdonk, HV

doi:10.1186/2197-425x-3-s1-a608

Cited by 4 publications

(4 citation statements)

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“…Different authors came out with different cut-off points. Some authors postulated lower cut-off values for ONSD (5.05-5.5 mm) [17][18][19]. By accepting slightly more restrictive cut-off value proposed by Lee (i.e., 5.5 mm), 70% of our patients on the first day of observation would have had ONSD above the upper limit.…”

Section: Discussionmentioning

confidence: 73%

“…In order to avoid any potential damage to the ocular structures, we followed the ALARA (as low as reasonably achievable) principle and guidelines of the British Medical Ultrasound Society [15,16]. We set the upper limit for ONSD at 5.7 mm [17]. In our ICU, ultrasonic measurement of ONSD is routinely used for monitoring of patients in whom sedation precludes neurological examination.…”

Section: Methodsmentioning

confidence: 99%

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Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

Czempik

Gąsiorek

Bąk

et al. 2020

IJERPH

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Sepsis-associated brain dysfunction (SABD) with increased intracranial pressure (ICP) is a complex pathology that can lead to unfavorable outcome. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is used for non-invasive assessment of ICP. We aimed to assess the role of ONSD as a SABD screening tool. This prospective preliminary study covered 10 septic shock patients (5 men; aged 65, IQR 50–78 years). ONSD was measured bilaterally from day 1 to 10 (n = 1), until discharge (n = 3) or death (n = 6). The upper limit for ONSD was set at 5.7 mm. Sequential organ failure assessment score was calculated on a daily basis as a surrogate formulti-organ failure due to sepsis in the study population. On day 1, the medians of right and left ONSD were 5.56 (IQR 5.35–6.30) mm and 5.68 (IQR 5.50–6.10) mm, respectively, and four subjects had bilaterally elevated ONSD. Forty-nine out of 80 total measurements performed (61%) exceeded 5.7 mm during the study period. We found no correlations between ONSD and sequential organ failure assessment (SOFA) during the study period (right: R = −0.13–0.63; left R = −0.24–0.63). ONSD measurement should be applied for screening of SABD cautiously. Further research is needed to investigate the exact role of this non-invasive method in the assessment of brain dysfunction in these patients.

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Section: Discussionmentioning

confidence: 73%

Section: Methodsmentioning

confidence: 99%

Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

Czempik

Gąsiorek

Bąk

et al. 2020

IJERPH

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“…To prevent any potential damage to the ocular structures, we complied with the ALARA principle (as low as reasonably achievable), according to the British Medical Ultrasound Society [19,20]. We set the upper limit for the ONSD at 5.7 mm [21]. In our ICU, ultrasonic measurement of the ONSD is routinely used for monitoring patients at risk of an increased ICP, particularly when sedation hinders neurological examination [22].…”

Section: Methodsmentioning

confidence: 99%

Hyperosmolar Treatment for Patients at Risk for Increased Intracranial Pressure: A Single-Center Cohort Study

Wiórek

Jaworski

Krzych

2020

IJERPH

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Treatment with osmoactive agents such as mannitol or hypertonic saline (HTS) solutions is widely used to manage or prevent the increase of intracranial pressure (ICP) in central nervous system (CNS) disorders. We sought to evaluate the variability and mean plasma concentrations of the water and electrolyte balance parameters in critically ill patients treated with osmotic therapy and their influence on mortality. This cohort study covered patients hospitalized in an intensive care unit (ICU) from January 2017 to June 2019 with presumed increased ICP or considered to be at risk of it, treated with 15% mannitol (G1, n = 27), a combination of 15% mannitol and 10% hypertonic saline (HTS) (G2, n = 33) or 10% HTS only (G3, n = 13). Coefficients of variation (Cv) and arithmetic means (mean) were calculated for the parameters reflecting the water and electrolyte balance, i.e., sodium (NaCv/NaMean), chloride (ClCv/ClMean) and osmolality (mOsmCv/mOsmMean). In-hospital mortality was also analyzed. The study group comprised 73 individuals (36 men, 49%). Mortality was 67% (n = 49). Median NaCv (G1: p = 0.002, G3: p = 0.03), ClCv (G1: p = 0.02, G3: p = 0.04) and mOsmCv (G1: p = 0.001, G3: p = 0.02) were higher in deceased patients. NaMean (p = 0.004), ClMean (p = 0.04), mOsmMean (p = 0.003) were higher in deceased patients in G3. In G1: NaCv (AUC = 0.929, p < 0.0001), ClCv (AUC = 0.817, p = 0.0005), mOsmCv (AUC = 0.937, p < 0.0001) and in G3: NaMean (AUC = 0.976, p < 0.001), mOsmCv (AUC = 0.881, p = 0.002), mOsmMean (AUC = 1.00, p < 0.001) were the best predictors of mortality. The overall mortality prediction for combined G1+G2+G3 was very good, with AUC = 0.886 (p = 0.0002). The mortality of critically ill patients treated with osmotic agents is high. Electrolyte disequilibrium is the independent predictor of mortality regardless of the treatment method used. Variations of plasma sodium, chloride and osmolality are the most deleterious factors regardless of the absolute values of these parameters

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“…Chen et al performed ultrasound measurement of ONSD 5 minutes before and after LP and found that ONSD correlated closely with real-time chan ges in CSFP ( 2 3 ). Weidner et al performed ultrasonographic measurement of ONSD in awake, spontaneously breathing patients with continuous invasive ICP monitoring, finding a strong correlation between ONSD and CSFP (24). Bauerle et al compared ultrasound and MRI derived values of ONSD, and found a high degree of agreement (25).…”

Section: Measurement Of Csf Pressurementioning

confidence: 99%

Problems in CSF and Ophthalmic Disease Research

Machiele¹,

Frankfort²,

Killer³

et al. 2022

Front. Ophthalmol.

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There has been significant interest and progress in the understanding of cerebrospinal fluid pressure and its relationship to glaucoma and other ophthalmic diseases. However, just as every physiologic fluid pressure fluctuates, cerebrospinal fluid pressure (CSFP) is similarly dynamic. Coupling this with the difficulty in measuring the pressure, there are many obstacles in furthering this field of study. This review highlights some of the difficulties in CSFP research, including fluid compartmentalization, estimation equations, and pressure fluctuation. Keeping these limitations in mind will hopefully improve the quality and context of this burgeoning field.

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Real-time evaluation of optic nerve sheath diameter (ONSD) in awake neurosurgical patients

Cited by 4 publications

References 0 publications

Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

Hyperosmolar Treatment for Patients at Risk for Increased Intracranial Pressure: A Single-Center Cohort Study

Problems in CSF and Ophthalmic Disease Research

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