Unit:
Κατεύθυνση Καρδιοαναπνευστική ΑναζωογόνησηLibrary of the School of Health Sciences
Author:
Sarantos Konstantinos
Supervisors info:
Νικολέττα Ιακωβίδου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Θεόδωρος Ξάνθος, Καθηγητής, Ιατρική Σχολή, Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Χαλκιάς Αθανάσιος, Επίκουρος Καθηγητής , Τμήμα Ιατρικής , Πανεπιστήμιο Θεσσαλίας
Original Title:
Ο λόγος της διαμέτρου του ελύτρου του οπτικού νεύρου προς την εγκάρσια διάμετρο του οφθαλμού και η θνητότητα, σε ασθενείς της ΜΕΘ με κρανιοεγκεφαλική κάκωση (ΚΕΚ) και παρακολούθηση ενδοεγκεφαλικής πίεσης
Translated title:
Ο λόγος της διαμέτρου του ελύτρου του οπτικού νεύρου προς την εγκάρσια διάμετρο του οφθαλμού και η θνητότητα, σε ασθενείς της ΜΕΘ με κρανιοεγκεφαλική κάκωση (ΚΕΚ) και παρακολούθηση ενδοεγκεφαλικής πίεσης
Summary:
Introduction:
The measurement of the optic nerve sheath diameter, as an indicator of elevated intracranial pressure (ICP), is a non invasive monitoring tool that is being used more commonly in recent years. The sensitivity and specificity of this method remains however inadequately investigated. Furthermore, the ratio of the optic nerve sheath diameter (ONSD) divided by eyeball transverse diameter (ETD) has been shown to have the capacity of providing more accurate information with regards to changes in ICP. The aim of this study is to investigate the correlation and prognostic value of the ONSD/ETD ratio in relation with Intensive Care Unit (ICU) mortality in patients with severe TBI as well as ICP monitoring.
Methods:
This is a retrospective study involving patients with traumatic brain injury (TBI) who were admitted to the Neuro ICU of a South London University Hospital. Demographic and clinical data were recorded as well as measurements derived from CT scans conducted at admission to the emergency department. Survivors were compared to non survivors based on the modified Rankin score.
Results:
73 patients were included in the study with a mean age of 42±16 years, 73 % male, admission GCS :7,2 ± 3,1 with a median ICU stay at 13 ± 8 days. ICU mortality was 25%. Higher values of ICP were observed in the non-survivor group.
We discovered a statistically significant difference of the ONSD/ETD ratio between survivors and non survivors [t (69) =-2.184, p=.032] with no correlation to mortality [rpb(71)=0.25, p=0.032].
Examining the correlation of the ONSD and the ONSD / ETD index with the first available recorded value of ICP upon entering the ICU, it emerged that: in the first case the correlation was ultimately low with [r (71) = 0.314, p = 0.008], while in the second [r (71) = 0.435, p <0.001]. However, when we focused on those patients who did not receive immediate neurosurgery, the correlation coefficient of ONSD/ETD index with ICP was stronger [r (42) = 0.607, p <0.001].
Conclusion:
The ONSD/ETD ratio , taking into account other eyeball and optic nerve parameters, could be used , not only as a prognostic indicator but also as an early and effective triage tool in patients with TBI and potentially increased ICP
Main subject category:
Health Sciences
Keywords:
Optic nerve sheath diameter, Traumatic brain injury, Eyeball transverese diameter, Intracranial pressure, Intensive care unit
