The use and uptake of pupillometers in the Intensive Care Unit

Lee, Matthew Hao; Mitra, Biswadev; Pui, Jiun Kae; Fitzgerald, Mark

doi:10.1016/j.aucc.2017.06.003

Cited by 21 publications

(16 citation statements)

References 15 publications

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“…The mean (standard deviation [SD]) was 56.4 years (22.3) for age, 6.8 days (7.7) for ICU length of stay, and 16.4 days (24.1) for hospital length of stay. The median (IQR) was 13 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) for GCS, 12 (6-15) for GCS-P, and 12 (6-14.5) for GCS- 2 displays the calculated MLE, standard error, 95% confidence interval (CI), and P-value for the four parameters; GCS, GCS-P, GCS-NPi, and avgNPi and for the covariates (age, sex, and ethnicity) in the NLMIXED model procedure after successful convergence. The MLE (95% CI) of total GCS was -0.17 (-0.22 to -0.12, P < 0.001), for GCS-P was -0.17 (-0.22 to -0.12, P < 0.001), for GCS-NPi was -0.17 (-0.22 to-0.12, P < 0.001), and for avgNPi was -0.39 (-0.57 to -0.22, P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…The most recent adaption to the GCS, the GCS-pupil (GCS-P) adjusts for findings based on a subjective assessment of the pupillary light reflex (PLR). However, both the GCS and GCS-P predate the adoption of automated infrared pupillometry (AIP) [6][7][8]. Therefore, the purpose of this study is to explore the contribution of PLR assessment to prognostication in patients with TBI.…”

Section: Introductionmentioning

confidence: 99%

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Contribution of pupillary light reflex assessment to Glasgow Coma Scale for prognostication in patients with traumatic brain injury

et al. 2021

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Background: Glasgow Coma Scale (GCS) and the pupillary light reflex (PLR) are important prognostic tools for traumatic brain injury (TBI). This study compared the predictability of GCS, GCS plus manual PLR (GCS-P), GCS plus Neurological Pupil index (GCS-NPi), and average NPi (avgNPi) in predicting discharge outcome in patients diagnosed with TBI. Methods: Data were obtained from a multicenter prospective registry that included 175 subjects with TBI. A nonlinear mixed model (NLMIXED) approach was used to determine which of the following independent variables (GCS, GCS-P, GCS-NPi, and avgNPi) is a better predictor of modified Rankin Scale (mRS) at discharge by fitting four predictive models for comparison. Results: The NLMIXED model for longitudinal data determined that GCS, GCS-P, GCS-NPi, and avgNPi were all significant predictors of mRS at discharge (P<0.001). Age was a significant predictor of the discharge mRS (P<0.001). There was a strong significant correlation between the four predicting variables (P<0.05). The maximum likelihood estimation (MLE) of GCS was -0.17 (P<0.001), MLE of GCS-P was -0.17 (P<0.001), MLE of GCS-NPi was -0.17 (P<0.001), and the MLE of avgNPi was -0.39 (P<0.001). Conclusion:Our findings suggest that any of the four variables (GCS, GCS-P, GCS-NPi, and avgNPi) could be used as a potential predictor of discharge mRS in a patient with TBI. This warrants future investigations to explore the combination of pupillary reactivity scores and NPi with GCS for prognostication in patients with TBI.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contribution of pupillary light reflex assessment to Glasgow Coma Scale for prognostication in patients with traumatic brain injury

et al. 2021

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“…It is still considered one of the main causes of death and life incapacity, and has an estimated incidence at 700 to 100,000 people. Pupillary response is widely known as crucial for screening, prognosis, and guiding the subsequent management of patients with brain lesions and therefore, it is vital that their evaluation is accurate and reproducible (23) . Not least, the evaluation of ocular movement with an adequacy index of more than 80.9% is fundamental for any ocular examination.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the self-eye examination method for health promotion

Lima

Nascimento²,

Silva

et al. 2018

Rev. esc. enferm. USP

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Objective:To evaluate the self-eye examination practice as a tool to promote the ocular self-evaluation. Method: Quasi-experimental study developed in a university of Piauí with sample of 324 students between January and May 2014. A team of thirteen researchers made observations during the self-examination followed by an ocular screening. Results: There was no agreement on the hypothesis of defense that the ocular exam could help to observe the eyes health, p-value>0.3. However, the exam was considered as easy to accomplish (99.7%) and that not only the physician can perform the eye exam (99.4%). The awareness about eye care is identified as the main purpose of this booklet (97.6%), (χ 2 = 186.01; p=0.001). The results highlight the booklet can be used in the teaching process of self-eye examination (84.6%). Although the defense that its fulfilment can replace the consultation with the ophthalmologist (23.8%%) cannot be accepted (χ 2 = 46.34), the self-exam must be done routinely (82.4%). Conclusion: The results prove that the learning through virtual booklet is possible and supports self-care with the eyes by performing the self-exam.

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“…The wellknown association of pupillary response with neurologic pathways has supported the use of QP as a routinely employed and effective measure in the assessment and prediction of outcomes for patients with diverse pathologies spanning traumatic brain injury and other neurological issues. [6][7][8][9][10] Already widely in use in critical care settings and with documented applications in the detection of neurological injuries and determination of efficacy of different interventions, QP may present value to emergency clinicians as a non-invasive, rapid, and precise diagnostic approach for use in the detection and treatment of intoxicated patients. Whether QP can be used to assess patients for intoxication or from ethanol or key drugs of abuse, and whether QP measurements of mental status change would be made unreliable because of intoxicated states, remains unknown.…”

Section: Background and Importancementioning

confidence: 99%