Re: Increase in Intracranial Pressure During Carbon Dioxide Pneumoperitoneum with Steep Trendelenburg Positioning Proven by Ultrasonographic Measurement of Optic Nerve Sheath Diameter

2015 ◽  
Vol 29 (1) ◽  
pp. 100-101 ◽  
Author(s):  
Ji-Hyun Chin ◽  
Dae-Kee Choi ◽  
Jai-Hyun Hwang ◽  
Young-Kug Kim
Keyword(s):  
Carbon Dioxide ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Nerve Sheath

scholarly journals Effects of positive end-expiratory pressure, carbon dioxide and body position on intracranial pressure measured by ultrasound assessment of optic nerve sheath diameter

2021 ◽  
Vol 74 (1-2) ◽  
pp. 45-49
Author(s):  
Adrijana Bojicic ◽  
Gordana Jovanovic ◽  
Filip Pajicic ◽  
Milanka Tatic
Keyword(s):  
Carbon Dioxide ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Body Position ◽  
Venous Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Positive End Expiratory Pressure ◽  
Nerve Sheath ◽  
Ultrasound Assessment

Introduction. The optic nerve is surrounded by layers of meninges and cerebrospinal fluid, which is why intracranial pressure affects the optic nerve sheath. Noninvasive measurement of the optic nerve sheath diameter is simple, accurate, repeatable and with minimal side effects. Effects of positive end-expiratory pressure on intracranial pressure. The application of positive end-expiratory pressure plays a significant role in improving gas exchange, but it leads to an increase in intrathoracic and central venous pressure, cerebral blood volume, reduces arterial and cerebral perfusion pressure and thus futher increases intracranial pressure. The effect of positive end-expiratory pressure depends on basal intracranial pressure and respiratory system compliance. Effects of carbon dioxide on intracranial pressure. Hypercapnia leads to cerebral vasodilatation and increases cerebral blood flow and intracranial pressure. Hypocapnia reduces intracranial pressure, but its prolonged effect may lead to cerebral ischemia. Effects of body position on intracranial pressure. Body position affects intracranial pressure, primarily by affecting cerebral venous drainage. Conclusion. Body position, application of positive end-expiratory pressure, and changes in carbon dioxide can affect intracranial pressure, which is why its monitoring is of importance. Numerous studies show that their effects on intracranial pressure can be easily monitored by ultrasound assessment of optic nerve sheath diameter.

scholarly journals Optic Nerve Sheath Diameter Correlation with Elevated Intracranial Pressure Determined via Ultrasound

Cureus ◽  
2019 ◽  
Author(s):  
Kamran Munawar ◽  
Muhammad Tariq Khan ◽  
Syed Waqar Hussain ◽  
Aayesha Qadeer ◽  
Zahid Siddique Shad ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Elevated Intracranial Pressure ◽  
Nerve Sheath

Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: a meta-analysis

2018 ◽  
Vol 60 (2) ◽  
pp. 221-229 ◽  
Author(s):  
Sung-Eun Kim ◽  
Eun Pyo Hong ◽  
Heung Cheol Kim ◽  
Si Un Lee ◽  
Jin Pyeong Jeon
Keyword(s):  
Optic Nerve ◽  
Intracranial Pressure ◽  
Meta Analysis ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Increased Intracranial Pressure ◽  
Summary Receiver Operating Characteristic ◽  
Nerve Sheath ◽  
Study Characteristics ◽  
Meta Regression

Background The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients. Purpose To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis. Material and Methods A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). A summary receiver operating characteristic (SROC) graph was used to provide summary points for sensitivity and specificity. Meta-regression tests were performed to estimate the influence of the study characteristics on DOR. Publication bias was assessed using Deeks' funnel plot asymmetry test. Results Six studies with 352 patients were included in the meta-analysis. US ONSD > 5.0 mm revealed pooled sensitivity of 99% (95% CI = 96–100) and specificity of 73% (95% CI = 65–80) for IICP detection. DOR was 178. The area under the SROC curve was 0.981, indicating a good level of accuracy. Meta-regression studies showed no significant associations between DOR and study characteristics such as probe mode (relative DOR [RDOR] = 0.60; P = 0.78), study quality (RDOR = 0.52; P = 0.67), IICP prevalence (RDOR = 0.04; P = 0.17), or pathology at admission (RDOR = 1.30; P = 0.87). Conclusion US ONSD > 5.0 mm can be used to rapidly detect IICP in adults in emergency departments and intensive care units. Further meta-analysis based on individual patient-level databases is needed to confirm these results.

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