Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients
Purpose Intracranial pressure (ICP) > 20 mmHg is associated with worse outcomes in children. The gold standard for monitoring ICP is invasive, has complications such as bleeding and infection, and may not be available in resource limited areas. Ultrasound of the optic nerve sheath diameter (ONSD)...
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| Veröffentlicht in: | Child's nervous system 2021-03, Vol.37 (3), p.951-957 |
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| creator | Biggs, Austin Lovett, Marlina Moore-Clingenpeel, Melissa O’Brien, Nicole |
| description | Purpose
Intracranial pressure (ICP) > 20 mmHg is associated with worse outcomes in children. The gold standard for monitoring ICP is invasive, has complications such as bleeding and infection, and may not be available in resource limited areas. Ultrasound of the optic nerve sheath diameter (ONSD) has been studied as a noninvasive way to evaluate for elevated ICP in adults. Its utility in pediatrics remains unclear.
Methods
A prospective study was performed in a pediatric intensive care unit in children ≤ 18 years old. ONSD ultrasound was performed using a 13–6 MHz linear probe with the patient’s invasively measured ICP simultaneously recorded. Linear mixed effects models were used to evaluate the association between ONSD and ICP.
Results
One hundred thirty-six measurements were obtained from 16 patients. ONSD was not significantly associated with ICP (
p
= 0.51). A ROC curve assessing ONSD to determine elevated ICP > 20 mmHg had an area under the curve of 0.52 (95%CI = 0.32–0.72). There was no difference in measurements obtained between the left and right ONSD at the same time (
p
= 0.82).
Conclusions
In conclusion, this study demonstrated no association between ONSD measurement and invasively monitored ICP in critically ill children. |
| doi_str_mv | 10.1007/s00381-020-04910-1 |
| format | Article |
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Intracranial pressure (ICP) > 20 mmHg is associated with worse outcomes in children. The gold standard for monitoring ICP is invasive, has complications such as bleeding and infection, and may not be available in resource limited areas. Ultrasound of the optic nerve sheath diameter (ONSD) has been studied as a noninvasive way to evaluate for elevated ICP in adults. Its utility in pediatrics remains unclear.
Methods
A prospective study was performed in a pediatric intensive care unit in children ≤ 18 years old. ONSD ultrasound was performed using a 13–6 MHz linear probe with the patient’s invasively measured ICP simultaneously recorded. Linear mixed effects models were used to evaluate the association between ONSD and ICP.
Results
One hundred thirty-six measurements were obtained from 16 patients. ONSD was not significantly associated with ICP (
p
= 0.51). A ROC curve assessing ONSD to determine elevated ICP > 20 mmHg had an area under the curve of 0.52 (95%CI = 0.32–0.72). There was no difference in measurements obtained between the left and right ONSD at the same time (
p
= 0.82).
Conclusions
In conclusion, this study demonstrated no association between ONSD measurement and invasively monitored ICP in critically ill children.</description><identifier>ISSN: 0256-7040</identifier><identifier>EISSN: 1433-0350</identifier><identifier>DOI: 10.1007/s00381-020-04910-1</identifier><identifier>PMID: 33009927</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Medicine ; Medicine & Public Health ; Neurosciences ; Neurosurgery ; Original Article</subject><ispartof>Child's nervous system, 2021-03, Vol.37 (3), p.951-957</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-ef2164d0ecb29395e2da5ef7068b3de0c336a448f6b86f11f3e22614dde84ac83</citedby><cites>FETCH-LOGICAL-c347t-ef2164d0ecb29395e2da5ef7068b3de0c336a448f6b86f11f3e22614dde84ac83</cites><orcidid>0000-0002-1434-9137</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00381-020-04910-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00381-020-04910-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33009927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biggs, Austin</creatorcontrib><creatorcontrib>Lovett, Marlina</creatorcontrib><creatorcontrib>Moore-Clingenpeel, Melissa</creatorcontrib><creatorcontrib>O’Brien, Nicole</creatorcontrib><title>Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients</title><title>Child's nervous system</title><addtitle>Childs Nerv Syst</addtitle><addtitle>Childs Nerv Syst</addtitle><description>Purpose
Intracranial pressure (ICP) > 20 mmHg is associated with worse outcomes in children. The gold standard for monitoring ICP is invasive, has complications such as bleeding and infection, and may not be available in resource limited areas. Ultrasound of the optic nerve sheath diameter (ONSD) has been studied as a noninvasive way to evaluate for elevated ICP in adults. Its utility in pediatrics remains unclear.
Methods
A prospective study was performed in a pediatric intensive care unit in children ≤ 18 years old. ONSD ultrasound was performed using a 13–6 MHz linear probe with the patient’s invasively measured ICP simultaneously recorded. Linear mixed effects models were used to evaluate the association between ONSD and ICP.
Results
One hundred thirty-six measurements were obtained from 16 patients. ONSD was not significantly associated with ICP (
p
= 0.51). A ROC curve assessing ONSD to determine elevated ICP > 20 mmHg had an area under the curve of 0.52 (95%CI = 0.32–0.72). There was no difference in measurements obtained between the left and right ONSD at the same time (
p
= 0.82).
Conclusions
In conclusion, this study demonstrated no association between ONSD measurement and invasively monitored ICP in critically ill children.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><issn>0256-7040</issn><issn>1433-0350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0EglL4ARbISzaB8SOvJap4SUjdwNpynQk1SpMwdkD8PYYWlqxGmjn3SnMYOxNwKQDKqwCgKpGBhAx0LSATe2wmtFIZqBz22QxkXmQlaDhixyG8Aoi8kvUhO1IKoK5lOWO0HKN3vEd6Rx7WaOOaN95uMCLxZsDA-yFyNxBhZyPyD58A30eyjmzvbcdHwhAmwrTlI6ZspJ_CiQZHPpUnxtl0H2302Mdwwg5a2wU83c05e769eVrcZ4_Lu4fF9WPmlC5jhq0UhW4A3UrWqs5RNjbHtoSiWqkGwSlVWK2rtlhVRStEq1DKQuimwUpbV6k5u9j2jjS8TRii2fjgsOtsj8MUjExhLWSp84TKLepoCIGwNSP5jaVPI8B8uzZb1ya5Nj-ujUih813_tNpg8xf5lZsAtQVCOvUvSOZ1mKhPP_9X-wVoGoxX</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Biggs, Austin</creator><creator>Lovett, Marlina</creator><creator>Moore-Clingenpeel, Melissa</creator><creator>O’Brien, Nicole</creator><general>Springer Berlin Heidelberg</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1434-9137</orcidid></search><sort><creationdate>20210301</creationdate><title>Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients</title><author>Biggs, Austin ; Lovett, Marlina ; Moore-Clingenpeel, Melissa ; O’Brien, Nicole</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-ef2164d0ecb29395e2da5ef7068b3de0c336a448f6b86f11f3e22614dde84ac83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biggs, Austin</creatorcontrib><creatorcontrib>Lovett, Marlina</creatorcontrib><creatorcontrib>Moore-Clingenpeel, Melissa</creatorcontrib><creatorcontrib>O’Brien, Nicole</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Child's nervous system</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biggs, Austin</au><au>Lovett, Marlina</au><au>Moore-Clingenpeel, Melissa</au><au>O’Brien, Nicole</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients</atitle><jtitle>Child's nervous system</jtitle><stitle>Childs Nerv Syst</stitle><addtitle>Childs Nerv Syst</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>37</volume><issue>3</issue><spage>951</spage><epage>957</epage><pages>951-957</pages><issn>0256-7040</issn><eissn>1433-0350</eissn><abstract>Purpose
Intracranial pressure (ICP) > 20 mmHg is associated with worse outcomes in children. The gold standard for monitoring ICP is invasive, has complications such as bleeding and infection, and may not be available in resource limited areas. Ultrasound of the optic nerve sheath diameter (ONSD) has been studied as a noninvasive way to evaluate for elevated ICP in adults. Its utility in pediatrics remains unclear.
Methods
A prospective study was performed in a pediatric intensive care unit in children ≤ 18 years old. ONSD ultrasound was performed using a 13–6 MHz linear probe with the patient’s invasively measured ICP simultaneously recorded. Linear mixed effects models were used to evaluate the association between ONSD and ICP.
Results
One hundred thirty-six measurements were obtained from 16 patients. ONSD was not significantly associated with ICP (
p
= 0.51). A ROC curve assessing ONSD to determine elevated ICP > 20 mmHg had an area under the curve of 0.52 (95%CI = 0.32–0.72). There was no difference in measurements obtained between the left and right ONSD at the same time (
p
= 0.82).
Conclusions
In conclusion, this study demonstrated no association between ONSD measurement and invasively monitored ICP in critically ill children.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33009927</pmid><doi>10.1007/s00381-020-04910-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1434-9137</orcidid></addata></record> |
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| ispartof | Child's nervous system, 2021-03, Vol.37 (3), p.951-957 |
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| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Medicine Medicine & Public Health Neurosciences Neurosurgery Original Article |
| title | Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients |
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