Journals / Turkish Journal of Pediatrics / 2021 / Cilt: 63 - Sayı: 2

Evaluation of ultrasonographic optic nerve sheath diameter and central retinal artery Doppler indices by point-of-care ultrasound in pediatric patients with increased intracranial pressure

Pages
303–306
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Our study is significant as one of the few pediatric studies where central retinal artery Doppler indices are evaluated in addition to OSND, in patients with increased ICP

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Measurement of the optic nerve sheath diameter (ONSD) with point-of-care ultrasound (POCUS) is a non-invasive and radiation-free technique that can be used to assess increased intracranial pressure (ICP).
📊
Key Findings & Data:Ophthalmic artery and central retinal artery Doppler indices can be used like transcranial Doppler to evaluate increased ICP.
💡
Conclusion & Impact:Our study is significant as one of the few pediatric studies where central retinal artery Doppler indices are evaluated in addition to OSND, in patients with increased ICP
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background. Measurement of the optic nerve sheath diameter (ONSD) with point-of-care ultrasound (POCUS) is a non-invasive and radiation-free technique that can be used to assess increased intracranial pressure (ICP). Ophthalmic artery and central retinal artery Doppler indices can be used like transcranial Doppler to evaluate increased ICP. This study aims to examine the diagnostic value of ONSD measurements and central retinal artery Doppler indices in the evaluation of pediatric patients with increased ICP. Methods. This was a prospective, case-controlled single center study. The study group was comprised of a total of 38 pediatric patients with increased ICP and the control group included 19 healthy children. Ophthalmic ultrasound was performed and ONSD and central retinal artery Doppler indices were measured. Results. The mean age of the study group was 80.84 ± 65.12 months. The mean ONSD was 5.9 ± 0.8 (3.6–8.1) mm in the study group and the mean resistive index (RI) was 0.71 ± 0.08 (min:0,55–max:1) and was significantly greater than the control group (p<0.001 and p<0.001, respectively). In terms of predicting increased ICP, the ONSD measurement was the strongest parameter, with its area under the curve: 0.767 (95 percent confidence interval: 0.68–0.85). In the study group, the cut-off value for ONSD was 5.8 mm (66 percent sensitivity, 100 percent specificity) and the cut-off value for RI was 0.68 (63 percent sensitivity, 83 percent specificity). Conclusions. Point-of-care ultrasound is a noninvasive and important tool in pediatric intensive care units. Our study is significant as one of the few pediatric studies where central retinal artery Doppler indices are evaluated in addition to OSND, in patients with increased ICP

🔖

Cite This Article

ASLAN, N., YILDIZDAŞ, D., HOROZ, Ö. Ö., ÖZSOY, M., YÖNTEM, A., ÇETİNALP, E., MERT, G. G. (2021). Evaluation of ultrasonographic optic nerve sheath diameter and central retinal artery Doppler indices by point-of-care ultrasound in pediatric patients with increased intracranial pressure. Turkish Journal of Pediatrics, Cilt: 63 - Sayı: 2, 303–306. https://ajindex.com/articles/411800

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (14)

  1. Goldsmith W, Plunkett J. A biomechanical analysis of the causes of traumatic brain injury in infants and children. Am J Forensic Med Pathol 2004; 25: 89-100
  2. Stocchetti N, Maas AIR. Traumatic intracranial hypertension. N Engl J Med 2014; 370: 2121-2130
  3. Robba C, Cardim D, Czosnyka M, et al. Ultrasound non-invasive intracranial pressure assessment in paediatric neurocritical care: a pilot study. Childs Nerv Syst 2020; 36: 117-124
  4. Robba C, Bragazzi NL, Bertuccio A, et al. Effects of prone position and positive end-expiratory pressure on noninvasive estimators of ICP: a pilot study. J Neurosurg Anesthesiol 2017; 29: 243-250
  5. Robba C, Cardim D, Tajsic T, et al. Ultrasound non- invasive measurement of intracranial pressure in neurointensive care: a prospective observational study. PLoS Med 2017; 14: e1002356
  6. Miglioretti DL, Johnson E, Williams A, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 2013; 167: 700-707
  7. Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med 2011; 364: 749-757
  8. O’Brien AJ, Brady RM. Point-of-care ultrasound in paediatric emergency medicine. J Paediatr Child Health 2016; 52: 174-180
  9. Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2011; 37: 1059-1068 10. Killer HE, Laeng HR, Flammer J, Groscurth P. Architecture of arachnoid trabeculae, pillars, and septa in the subarachnoid space of the human optic nerve: anatomy and clinical considerations. Br J Ophthalmol 2003; 87: 777-781
  10. CShirodkar CG, S. Rao SM, Mutkule DP, Harde YR, Venkategowda PM, Mahesh MU. Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: an observational study. Indian J Crit Care Med 2014; 18: 728-734
  11. Dubost C, Le Gouez A, Zetlaoui PJ, Benhamou D, Mercier FJ, Geeraerts T. Increase in optic nerve sheath diameter induced by epidural blood patch: a preliminary report. Br J Anaesth 2011; 107: 627-630
  12. Xirouchaki N, Magkanas E, Vaporidi K, et al. Lung ultrasound in critically ill patients: comparison with bedside chest radiography. Intensive Care Med 2011; 37: 1488-1493
  13. Jang T, Aubin C. The use of serial ocular ultrasonography in the care of patients with a head injury. Ann Emerg Med 2005; 45: 336-337
  14. Guidance f