Comparison of ultrasonographic measurement of optic nerve sheath diameter ONSD versus direct measurement of intracranial pressure ICP in traumatic brain injury patientsReport as inadecuate




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Signa vitae : journal for intesive care and emergency medicine, Vol.6 No.1 April 2011. -

Aim. To compare ultrasonographic measurement of optic nerve sheath diameter ONSD with direct measurement of intracranial pressure ICP and evaluate the correlation between them in traumatic brain injury patients.

Patients and methods. Twenty traumatic brain injury patients were enrolled in the study. Patients had a median Glasgow Coma Scale GCS score of 5. All patients underwent noninvasive measurement of ICP by ultrasonographic measurement of ONSD and invasive ICP measurement using an intraventricular catheter. We used MedCalc to analyze data.

Results. We compared the ONSD measurement in patients with ICP less than 20 cm H2O with patients with ICP greater than 20 cm H2O. The mean ONSD for 8 patients with ICP > 20 cmH2O was 7.6 +- 0.8 mm, and for 18 patients with ICP 20 cm H2O was 6.1, with sensitivity of 100 % and specificity of 83 %. the area under the curve was 0.98, 95 % CI = 0.825-0.990. In this study, the usually used cutoff of ONSD > 5 mm gives a sensitivity of 100 %, but a specificity of only 22 %.

Conclusion. Ultrasonographic measurement of ONSD correlates with direct measurement of ICP. This method has potential as a screening test for elevated ICP in traumatic brain injury.

ultrasound; ONSD; ICP



Author: Mladen Širanović - ; Department of Anesthesiology and Intensive Care, University Hospital -Sestre milosrdnice-, Vinogradska 29,

Source: http://hrcak.srce.hr/



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