Ultrasonographic Optic Nerve Sheath Diameter Is Correlated With Arterial Carbon Dioxide Concentration During Reperfusion in Liver Transplant Recipients

Seo, Hong Joo; Kim, Young‐Kug; Shin, Won-Jung; Hwang, GS

doi:10.1016/j.transproceed.2012.12.032

Cited by 23 publications

(14 citation statements)

References 23 publications

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“…Although ONSD is well responsive to ICP change [12], it may show a delayed response in the case of highly increased ICP [12,13]. Moreover, despite of the association between ONSD and PaCO 2 [14], the dynamic responsiveness of ONSD, in association with acute arterial CO 2 change which can affect ICP, still has not been well investigated.…”

Section: Introductionmentioning

confidence: 99%

Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia

Kim

Min

et al. 2014

Korean J Anesthesiol

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BackgroundRapid evaluation and management of intracranial pressure (ICP) can help to early detection of increased ICP and improve postoperative outcomes in neurocritically-ill patients. Sonographic measurement of optic nerve sheath diameter (ONSD) is a non-invasive method of evaluating increased intracranial pressure at the bedside. In the present study, we hypothesized that sonographic ONSD, as a surrogate of ICP change, can be dynamically changed in response to carbon dioxide change using short-term hyperventilation.MethodsFourteen patients were enrolled. During general anesthesia, end-tidal carbon dioxide concentration (ETCO2) was decreased from 40 mmHg to 30 mmHg within 10 minutes. ONSD, which was monitored continuously in the single sonographic plane, was repeatedly measured at 1 and 5 minutes with ETCO2 40 mmHg (time-point 1 and 2) and measured again at 1 and 5 minutes with ETCO2 30 mmHg (time-point 3 and 4).ResultsThe mean ± standard deviation of ONSD sequentially measured at four time-points were 5.0 ± 0.5, 5.0 ± 0.4, 3.8 ± 0.6, and 4.0 ± 0.4 mm, respectively. ONSD was significantly decreased at time-point 3 and 4, compared with 1 and 2 (P < 0.001).ConclusionsThe ONSD was rapidly changed in response to ETCO2. This finding may support that ONSD may be beneficial to close ICP monitoring in response to CO2 change.

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Section: Introductionmentioning

confidence: 99%

Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia

Kim

Min

et al. 2014

Korean J Anesthesiol

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“…5 ONSD measurement using bedside ultrasound has been shown to correlate with clinical and radiologic signs and symptoms of raised ICP. [6][7][8][9] Despite the association between ONSD and PaCO 2 , 10 there is scanty literature on ONSD responsiveness to a more dynamic surrogate of PaCO 2 , that is, EtCO 2 . The pertinent advantages of EtCO 2 over PaCO 2 measurement is that the former is continuously monitored under anesthesia and avoids time-consuming process of arterial blood gas sampling.…”

Section: Discussionmentioning

confidence: 99%

Changes in Optic Nerve Sheath Diameter in Response to Various Levels of End-Tidal Carbon Dioxide in Healthy Patients under General Anesthesia

Kapoor

Khandelwal

Mahajan

et al. 2018

Journal of Neuroanaesthesiology and Critical Care

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Background Intracranial pressure (ICP) monitoring is an essential component in management of traumatic brain-injured (TBI) patients. While invasive techniques are associated with many complications, noninvasive nature of ultrasonographic measurement of optic nerve sheath diameter (ONSD) is now becoming popular. Carbon dioxide (CO 2 ) alters the ICP by changing the size of cerebral vasculature. We aimed to assess the effect of (hypercarbia and hypocarbia) different levels of end-tidal carbon dioxide (EtCO 2 ) on ONSD. Methods Thirty adult patients aged between 18 and 65 years, undergoing brachial plexus injury surgery under general anesthesia, were enrolled. Following standard anesthetic protocol, ONSD was measured at different time points of EtCO 2 . ONSD was measured at EtCO 2 of 40 and then 30 mm Hg to assess change in ONSD due to hypocarbia (T hypocarbia ). Similarly, ONSD was measured at EtCO 2 of 50 mm Hg to assess change in ONSD due to hypercarbia (T hypercarbia ). The mean of three ONSD values at each time point was taken as the final value. The generalized estimating equation (GEE) was used to analyze correlation between different levels of EtCO 2 and ONSD. Results The calculated 95% confidence interval (CI) for the difference of two measures (T hypocarbia, EtCO 2 40 and 30 mm Hg) on ONSD was −0.056 to −0.036, and the calculated CI for the difference of other two measures (T hypercarbia, EtCO 2 40 and 50 mm Hg) on ONSD was 0.044 to 0.077, and thus were observed to be significant. Conclusions ONSD changes significantly in response to different EtCO 2 levels in healthy non-neurosurgical patients under general anesthesia. AbstractKeywords ► optic nerve sheath diameter ► end-tidal carbon dioxide ► intracranial pressure ► hypocapnia ► hypercapnia J Neuroanaesthesiol Crit Care 2018;5:94-97.

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“…In the sole study published relating to PALF, raised ONSD on admission and absence of response to therapy was found to be associated with mortality. 15 In adults undergoing liver transplantation, ONSD has been shown to increase significantly in the reperfusion phase, 17 and, in a single case report, had been used successfully as the basis for intervention for presumed raised ICP. 16 The majority of studies in adults use a cutoff of ≥5 mm as indicative of raised ICP, which demonstrates reasonable diagnostic accuracy.…”

Section: Does Measurement Of Ocular Nerve Sheath Diameter and Tympamentioning

confidence: 99%

“…Multiple techniques for directly or indirectly assessing one or more of these variables have been proposed. In this review, we examine the assessment of ONSD, [15][16][17] NIRS, [18][19][20] and monitoring of jugular venous saturations, [21][22][23][24][25][26][27] as well TCD, the technique that arguably has the greatest supporting evidence in adults.…”

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confidence: 99%

Neurocritical care monitoring of encephalopathic children with acute liver failure: A systematic review

Hunt

Tasker

Deep

2019

Pediatric Transplantation

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Research on non‐invasive neuromonitoring specific to PALF is limited. This systematic review identifies and synthesis the existing literature on non‐invasive approaches to monitoring for neurological sequelae in patients with PALF. A series of literature searches were performed to identify all publications pertaining to five different non‐invasive neuromonitoring modalities, in line with PRISMA guidelines. Each modality was selected on the basis of its potential for direct or indirect measurement of cerebral perfusion; studies on electroencephalographic monitoring were therefore not sought. Data were recorded on study design, patient population, comparator groups, and outcomes. A preponderance of observational studies was observed, most with a small sample size. Few incorporated direct comparisons of different modalities; in particular, comparison to invasive intracranial pressure monitoring was largely lacking. The integration of current evidence is considered in the context of the clinically significant distinctions between pediatric and adult ALF, as well as the implications for planning of future investigations to best support the evidence‐based clinical care of these patients.

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Ultrasonographic Optic Nerve Sheath Diameter Is Correlated With Arterial Carbon Dioxide Concentration During Reperfusion in Liver Transplant Recipients

Cited by 23 publications

References 23 publications

Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia

Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia

Changes in Optic Nerve Sheath Diameter in Response to Various Levels of End-Tidal Carbon Dioxide in Healthy Patients under General Anesthesia

Neurocritical care monitoring of encephalopathic children with acute liver failure: A systematic review

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