Document Detail


Effect of osmotherapy on optic nerve sheath diameter in patients with increased intracranial pressure.
MedLine Citation:
PMID:  24372319     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The measurement of ocular nerve sheath diameter (ONSD) via ocular ultrasound scanning is a recent non-invasive method for intracranial pressure (ICP) assessment. Few clinical studies have assessed ONSD variations during osmotherapy for the treatment of sustained increased ICP episodes. The aim of our study was to determine the rate of ONSD variation after mannitol administration for increased ICP episodes. We consecutively included in a prospective, observational study, the patients who had severe acute brain injury and monitored with an invasive ICP monitor. For each episode of sustained elevated ICP, the ONSD was measured in the right and left eye with a 7.5-MHz echography probe, and the mean value was reported. Simultaneously, ICP and cerebral perfusion pressure (CPP) were recorded. All measurements were performed just before and 20 minutes following a 20% mannitol infusion. Data were expressed as medians and interquartile ranges. Thirteen patients were included and analysed (traumatic brain injury, n=10; subarachnoid haemorrhage, n=3). The median value of the mannitol dose infused was 0.54 g/kg (0.49-0.80 g/kg). In all cases, the ONSD was greater than 5.8 mm before osmotherapy. The ONSD significantly decreased after mannitol infusion from 6.3 (6.1-6.7) to 5. mm (5.5-6.3) (p=0.0007). Concomitantly, the intracranial pressure decreased from 35 (32-41) to 25 (22-29) mmHg (p=0.001) and the CPP increased from 47 (50-60) to 66 (59-69) mmHg (p=0.003). The variations of ONSD appear to be an interesting parameter to evaluate the efficacy of osmotherapy for elevated ICP episodes in patients with acute brain injury.
Authors:
Yoann Launey; Nicolas Nesseler; Pascale Le Maguet; Mallédant Yannick; Seguin Philippe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-28
Journal Detail:
Title:  Journal of neurotrauma     Volume:  -     ISSN:  1557-9042     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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