Susanne R Kerscher1,2, Daniel Schöni3,4, Felix Neunhoeffer5, Markus Wolff6, Karin Haas-Lude6, Andrea Bevot6, Martin U Schuhmann7,3. 1. Department of Neurosurgery, Pediatric Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany. susanne.kerscher@med.uni-tuebingen.de. 2. Department of Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany. susanne.kerscher@med.uni-tuebingen.de. 3. Department of Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany. 4. Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland. 5. Pediatric Intensive Care Unit, Childrens' Hospital, University Hospital of Tuebingen, Tuebingen, Germany. 6. Department of Pediatric Neurology and Developmental Medicine, Childrens' Hospital, University Hospital of Tuebingen, Tuebingen, Germany. 7. Department of Neurosurgery, Pediatric Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany.
Abstract
PURPOSE: Previous studies correlating ultrasound (US)-based optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in children were performed under general anesthesia. To apply ONSD in daily clinical routine, it is necessary to investigate patients awake. It is furthermore essential for ICP-assessment with ONSD to know if ONSD-ICP correlation varies within individuals. In this study, we report on the influence of wakefulness, method of ICP measurement, intraindividual correlations, and dynamic changes of ONSD and ICP after ICP decreasing therapy. METHODS: The overall study included 72 children with a median age of 5.2 years. US ONSD determination was performed immediately prior to invasive ICP measurement, and the mean binocular ONSD was compared to ICP. In 10 children, a minimum of 3 ONSD/ICP measurements were performed to investigate a correlation within subjects. In 30 children, measurements were performed before and after therapy. RESULTS: Twenty-eight children were investigated awake with an excellent correlation of ONSD and ICP (r = 0.802, p < 0.01). In 10 children, at least three simultaneous ONSD and ICP measurements were performed. The intraindividual correlations were excellent (r = 0.795-1.0) however with strongly differing individual regression curves. The overall correlation within subjects was strong (r = 0.78, p < 0.01). After ICP decreasing therapy, all ONSD values decreased significantly (p < 0.01); however, there was no correlation between ∆ICP and ∆ONSD. CONCLUSION: Awake investigation does not impair the correlation between ONSD and ICP. Even if there is a good overall ONSD-ICP correlation, every individual has its own distinctive and precise correlation line. The relationship between ONSD and ICP is furthermore not uniform between individuals. Strong ICP decreases can lead to smaller ONSD changes and vice versa. This should be kept in mind when using this technique in the clinical daily routine.
PURPOSE: Previous studies correlating ultrasound (US)-based optic nerve sheath diameter (ONSD) and intracranial pressure (ICP) in children were performed under general anesthesia. To apply ONSD in daily clinical routine, it is necessary to investigate patients awake. It is furthermore essential for ICP-assessment with ONSD to know if ONSD-ICP correlation varies within individuals. In this study, we report on the influence of wakefulness, method of ICP measurement, intraindividual correlations, and dynamic changes of ONSD and ICP after ICP decreasing therapy. METHODS: The overall study included 72 children with a median age of 5.2 years. US ONSD determination was performed immediately prior to invasive ICP measurement, and the mean binocular ONSD was compared to ICP. In 10 children, a minimum of 3 ONSD/ICP measurements were performed to investigate a correlation within subjects. In 30 children, measurements were performed before and after therapy. RESULTS: Twenty-eight children were investigated awake with an excellent correlation of ONSD and ICP (r = 0.802, p < 0.01). In 10 children, at least three simultaneous ONSD and ICP measurements were performed. The intraindividual correlations were excellent (r = 0.795-1.0) however with strongly differing individual regression curves. The overall correlation within subjects was strong (r = 0.78, p < 0.01). After ICP decreasing therapy, all ONSD values decreased significantly (p < 0.01); however, there was no correlation between ∆ICP and ∆ONSD. CONCLUSION: Awake investigation does not impair the correlation between ONSD and ICP. Even if there is a good overall ONSD-ICP correlation, every individual has its own distinctive and precise correlation line. The relationship between ONSD and ICP is furthermore not uniform between individuals. Strong ICP decreases can lead to smaller ONSD changes and vice versa. This should be kept in mind when using this technique in the clinical daily routine.
Authors: Oliver Ganslandt; Stylianos Mourtzoukos; Andreas Stadlbauer; Björn Sommer; Rudolf Rammensee Journal: J Neurosurg Date: 2017-08-08 Impact factor: 5.115
Authors: V Neubauer; E Griesmaier; K Baumgartner; A Mallouhi; M Keller; U Kiechl-Kohlendorfer Journal: Acta Paediatr Date: 2011-07-08 Impact factor: 2.299
Authors: Steven S Laurie; Gianmarco Vizzeri; Giovanni Taibbi; Connor R Ferguson; Xiao Hu; Stuart M C Lee; Robert Ploutz-Snyder; Scott M Smith; Sara R Zwart; Michael B Stenger Journal: Physiol Rep Date: 2017-06