| Can Intraocular Pressure Measurements Be Used To Screen For Elevated Intracranial Pressure In Emergency Department Patients? | |
| | |
MedLine Citation:
|
PMID: 20580516 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: Handheld measurement of intraocular pressure (IOP) has been previously shown to accurately predict elevated intracranial pressure (ICP) in neurosurgical patients. Handheld tonometry may have clinical utility in the prediction of elevated ICP among a cohort of emergency department (ED) patients receiving lumbar puncture (LP). OBJECTIVE: To ascertain the sensitivity and specificity of IOP for the prediction of elevated ICP in ED patients undergoing LP. METHODS: In this prospective observational pilot study, all ED patients over the age of 18 years and undergoing LP in the ED for any reason were eligible to participate. Study participants had IOP measured with the Tono-Pen XL (Reichert, Inc., Depew, NY) while in the supine position before LP. OP was measured in the lateral recumbent position. Elevated IOP was defined as>/=20mm Hg; elevated ICP was defined as>/=20mm H(2)O. RESULTS: There were 82 patients screened and 46 patients enrolled at the time of interim analysis. Of the 46 patients, 32 had a successful LP in the lateral recumbent position. There were 18/32 patients with a successful LP in the lateral recumbent position who had elevated opening pressure; 9/32 patients with a successful LP had an elevated IOP. Furthermore, 4/9 patients with elevated IOP also had an elevated opening pressure. There was only one patient who had elevated IOP, elevated ICP, and diagnostic cerebrospinal fluid (sensitivity 24%, 95% confidence interval [CI] 9-48%; specificity 63%, 95% CI 32-88%; positive predictive value 28%, 95% CI 14-47%; negative predictive value 72%, 95% CI 53-96%). CONCLUSIONS: Handheld tonometry has poor sensitivity and specificity for the prediction of increased ICP, and should not be used as a screening tool in the ED. |
| | |
Authors:
|
Tim Muchnok; Ken Deitch; Patricia Giraldo |
Related Documents
:
|
7198366 - A diurnal study of the ocular hypotensive effect of metoprolol mounted on ophthalmic ro... 20570236 - Intraocular pressure and related systemic and ocular biometric factors in a population-... 8773166 - Comparison of the ocular beta-blockers. 3335426 - Effect of cold air on aqueous humor dynamics in humans. 19875896 - Large blood pressure variability and hypertensive cardiac remodeling--role of cardiac i... 9710106 - Capillary refilling time and hemodynamics in neonates: a doppler echocardiographic eval... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2010-6-25 |
Journal Detail:
|
Title: The Journal of emergency medicine Volume: - ISSN: 0736-4679 ISO Abbreviation: - Publication Date: 2010 Jun |
Date Detail:
|
Created Date: 2010-6-28 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Treating Critical Illness Caused by the 2009 H1N1 Influenza A Virus.
Next Document: Utilization of emergency medical services by patients with acute coronary syndromes in the arab gulf...