scholarly journals Comment on “Optic Nerve Sheath Diameter Ultrasound Evaluation in Intensive Care Unit: Possible Role and Clinical Aspects in Neurological Critical Patients’ Daily Monitoring”

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Maddalena De Bernardo ◽  
Nicola Rosa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Optic Nerve ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Clinical Aspects ◽  
Daily Monitoring ◽  
Nerve Sheath ◽  
Ultrasound Evaluation ◽  
Critical Patients

scholarly journals Optic Nerve Sheath Diameter Ultrasound Evaluation in Intensive Care Unit: Possible Role and Clinical Aspects in Neurological Critical Patients’ Daily Monitoring

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
M. Toscano ◽  
G. Spadetta ◽  
P. Pulitano ◽  
M. Rocco ◽  
V. Di Piero ◽  
...  
Keyword(s):  
Intensive Care ◽  
Optic Nerve ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Neurological Diseases ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Daily Monitoring ◽  
Nerve Sheath ◽  
Critical Patients

Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD).Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD. 31 nonneurological controls were used for standard ONSD reference.Results. Patients with neurological diseases, before BD, showed higher ONSD values than control group (CTRL: RT0.45±0.03 cm; LT0.45±0.02 cm; pre-BD: RT0.54±0.02 cm; LT0.55±0.02 cm;p<0.000) even without intracranial hypertension, evaluated with invasive monitoring. ONSD was further significantly markedly increased in respect to the pre-BD evaluation in neurocritical patients after BD, with mean values above 0.7 cm (RT0.7±0.02 cm; LT0.71±0.02 cm;p<0.000), with a corresponding dramatic raise in intracranial pressure. Logistic regression analysis showed a strong correlation between ONSD and ICP (R0,895,p<0.001).Conclusions. ONSD is a reliable marker of intracranial hypertension, easy to be performed with a minimal training. Routine ONSD daily monitoring could be of help in Intensive Care Units when invasive intracranial pressure monitoring is not available, to early recognize intracranial hypertension and to suspect BD in neurocritical patients.

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