Please use this identifier to cite or link to this item: doi:10.22028/D291-34595
Title: Real-Time Evaluation of Optic Nerve Sheath Diameter (ONSD) in Awake, Spontaneously Breathing Patients
Author(s): Weidner, Nick
Kretschmann, Jessica
Bomberg, Hagen
Antes, Sebastian
Leonhardt, Steffen
Tschan, Christoph
Oertel, Joachim
Volk, Thomas
Meiser, Andreas
Groesdonk, Heinrich V.
Language: English
Title: Journal of Clinical Medicine
Volume: 10
Issue: 16
Publisher/Platform: MDPI
Year of Publication: 2021
Free key words: elevated intracranial pressure
non-invasive ICP measurement
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: (1) Background: Reliable ultrasonographic measurements of optic nerve sheath diameter (ONSD) to detect increased intracerebral pressure (ICP) has not been established in awake patients with continuous invasive ICP monitoring. Therefore, in this study, we included fully awake patients with and without raised ICP and correlated ONSD with continuously measured ICP values. (2) Methods: In a prospective study, intracranial pressure (ICP) was continuously measured in 25 patients with an intraparenchymatic P-tel probe. Ultrasonic measurements were carried out three times for each optic nerve in vertical and horizontal directions. ONSD measurements and ICP were correlated. Patients with ICP of 2.0–10.0 mmHg were compared with patients suffering from an ICP of 10.1–24.2 mmHg. (3) Results: In all patients, the ONSD vertical and horizontal measurement for both eyes correlated well with the ICP (Pearson R = 0.68–0.80). Both measurements yielded similar results (Bland-Altman: vertical bias: −0.09 mm, accuracy: ±0.66 mm; horizontal bias: −0.06 mm, accuracy: ±0.48 mm). For patients with an ICP of 2.0–10.0 mmHg compared to an ICP of 10.1–24.2, ROC (receiver operating characteristic) analyses showed that ONSD measurement accurately predicts elevated ICP (optimal cut-off value 5.05 mm, AUC of 0.91, sensitivity 92% and specificity 90%, p < 0.001). (4) Conclusions: Ultrasonographic measurement of ONSD in awake, spontaneously breathing patients provides a valuable method to evaluate patients with suspected increased ICP. Additionally, it provides a potential tool for rapid assessment of ICP at the bedside and to identify patients at risk for a poor neurological outcome.
DOI of the first publication: 10.3390/jcm10163549
Link to this record: urn:nbn:de:bsz:291--ds-345953
ISSN: 2077-0383
Date of registration: 30-Aug-2021
Faculty: M - Medizinische Fakultät
Department: M - Anästhesiologie
M - Neurochirurgie
Professorship: M - Prof. Dr. Joachim Oertel
M - Prof. Dr. Thomas Volk
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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