Original scientific paper
Comparison of ultrasonographic measurement of optic nerve sheath diameter (ONSD) versus direct measurement of intracranial pressure (ICP) in traumatic brain injury patients
Mladen Širanović
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Tihana Magdić Turković
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Aleksandar Gopčević
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Mijo Kelečić
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Nataša Kovač
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Josip Kovač
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Bojan Rode
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Marinko Vučić
; Department of Anesthesiology and Intensive Care, University Hospital "Sestre milosrdnice", Vinogradska 29, 10000 Zagreb, Croatia
Abstract
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.
Keywords
Hrčak ID:
67467
URI
Publication date:
1.4.2011.
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