Comparison of Ultrasound Guided Optic Nerve Sheath Diameter Measurements with Other Cranial Imaging Methods (Cranial Computed Tomography and Magnetic Resonance Imaging) in Pediatric Intensive Care Patients
Journal Title: Çocuk Acil ve Çocuk Yoğun Bakım Dergisi - Year 2019, Vol 6, Issue 1
Abstract
Introduction: Optic nerve sheath diameter (ONSD) measurements aid in diagnosis of increased intracranial pressure (ICP). Computed tomography (CT) and magnetic resonance imaging (MRI) are commonly used modalities for detecting ICP. Lately, ONSD measurements via ultrasound (US) are getting popular as an alternative method due to the ease of performance at the bedside and repeatability. Our study objective was to investigate whether US measurements correlated with CT/MRI counterparts. Methods: This was a single-center, prospective study. All intubated patients aged 1 month-18 years with a cranial CT/MRI for any indications, who could be scanned ultrasonographically, were included after parental consent. Optic nerve US was performed by a single investigator. CT/MRI ONSDs were measured by a neuro-radiologist. Data obtained from US and CT/MRI scans were compared. Results: A total of 94 different measurements were obtained. The mean ONSD in US and CT was 4.56±0.66 cm and 4.65±0.72cm on the right side, whereas the mean left ONSD was 4.52±0.63 cm and 4.46±0.67 cm, respectively (p=0.4). Correlation coefficient for right ONSD was r=0.448 (p=0.002) while it was r=0.448 (p=0.001) for left ONSD. Both CT and US measurements showed a linear increase, and the correlation between them was moderate. A subgroup of 8 patients who had less than 5 hours between their central imaging and US scan showed strong correlation between measurements for both right and left ONSD [r=0.774, (p=0.024) and r=0.811 (p=0.014), respectively]. Conclusion: There was a correlation between US and CT/MRI ONSD measurements in our study. The correlation was stronger when the time interval was less than 5 hours between measurements. Our findings suggest that US may be a useful, reliable and cost-effective method for assessment and clinical follow-up of increased ICP in intubated pediatric intensive care unit patients.
Authors and Affiliations
Burcu Dadı, Emel Uyar, Ruslan Asadov, Feyza İnceköy Girgin, Gazanfer Ekinci, Nilüfer Yalındağ Öztürk
Peripheral Symmetrical Gangrene Due to Escherichia Coli Sepsis
Symmetrical peripheral gangrene is ischemia of two or more regions without great vein obstruction. This condition is a rare complication of sepsis, but also has a high mortality rate. Half of the patients require amputat...
Successful Intravenous Lipid Infusion Therapy in a Case with Life-Threatening Calcium Channel and Beta Blockers Overdose
Life-threatening cardiovascular collapse symptoms can develop due to calcium channel and beta-receptor blocker overdose and there are no specific antidotes for treatment. A 13-year-old girl was admitted with severe hypo...
Response From Authors: Evaluation of Patients Diagnosed with Brain Death in Pediatric Critical Care
.
Urolithiasis Frequency and Risk Factors in Home Ventilated Patients with Tracheostomy
Giriş: Bu çalışmada, ev tipi ventilatör ile izlenen trakeostomili hastalarda ürolitiazis sıklığı ve risk faktörlerinin değerlendirilmesi amaçlanmıştır. Yöntemler: Ocak 2014 ve Aralık 2015 tarihleri arasında çocuk yoğun b...
Non-Invasive Mechanical Ventilation Practice in Pediatric Intensive Care Unit: A Retrospective Study
Introduction: To investigate demographic, clinical and laboratory features and to determine the indications for non-invasive ventilation (NIV), ventilation parameters and NIV success among patients who received NIV thera...