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Clinical research
DOI: 10.1016/j.neucie.2021.02.004
Available online 28 February 2021
Usefulness of the optic nerve sheath ultrasound in patients with cessation of cerebral flow
Utilidad de la ecografía de la vaina del nervio óptico en pacientes con cese de flujo cerebral
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Alejandro Robles-Caballeroa,b, María Angélica Henríquez-Recinea,b, Raúl Juárez-Velab,c,
Corresponding author
raul.juarez@unirioja.es

Corresponding author.
, Luís García-Olmosd, Santiago Yus-Teruela,b, Manuel Quintana-Díaza,b
a Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain
b Grupo BMP, Instituto de Investigación-IdiPaz, Madrid, Spain
c Universidad de la Rioja, Logroño, Spain
d Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Sureste, Madrid, Spain
Received 23 May 2020. Accepted 03 November 2020
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Figures (1)
Tables (3)
Table 1. Demographic characteristics. Diagnoses for admission to the ICU.
Table 2. Severity and neurological characteristics.
Table 3. Results of the ocular ultrasound. Optic nerve sheath diameter (ONSD) and optic nerve diameter (OND).
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Abstract

Optic nerve sheath diameter (ONSD) ultrasound has proven to be a useful tool for the detection of intracranial hypertension (IH). The DVNO values, in patients with cessation of cerebral blood flow (CCBF), has not been clarified yet.

Objective

Establish an association between DVNO and CFSC in neurocritical patients admitted to an ICU.

Patients and methods

Cross-sectional study of patients admitted in a third level ICU, between April 2017 and April 2018, with neurological pathology. ONSD ultrasound was performed in the first 24 h and as the patient was diagnosed of CCBF. The ONSD values of patients with and without diagnosis of CCBF were compared.

Results

99 patients were included, 29 of whom showed CCBF in transcranial Doppler. The ONSD measurement did not demonstrate significant differences between both groups, 65.94 ± 7.55 in the group with CCBF and 63.88 ± 5.56 in the group without CCBF, p = 0.14.

Conclusion

In our study, ONSD values capable of recognizing CCBF were not identified.

Keywords:
Ultrasonography
Optic nerve
Brain death
Intracranial hypertension
Cerebrovascular circulation
Resumen

La ecografía del diámetro de la vaina del nervio óptico (DVNO), ha demostrado ser una herramienta útil para la detección de hipertensión intracraneal (HIC). Los valors del DVNO en pacientes con cese del flujo sanguíneo cerebral (CFSC), todavía no han sido definidos.

Objetivo

Establecer asociación entre el DVNO y el CFSC en pacientes neurocríticos ingresados en una UCI.

Pacientes y métodos

Estudio transversal de pacientes ingresados en una UCI polivalente de tercer nivel, con patología neurológica, entre abril de 2017 y abril de 2018. Se incluyeron en el estudio pacientes neurocríticos con alteraciones clínico radiológicas. Se realizó una ecografía del DVNO en las primeras 24 h de ingreso, que se repitió en aquellos pacientes con evolución a CFSC, establecido mediante Doppler transcraneal. Se compararon los valorares de DVNO de los pacientes con y sin diagnóstico de CFSC.

Resultados

Se incluyeron 99 pacientes de los cuales 29 mostraron CFSC por Doppler transcraneal. La medición del DVNO no mostró diferencias significativas entre ambos grupos, 6,59 ± 0,75 en el grupo con CSFC y 6,39 ± 0,56 en el grupo sin CSFC, p = 0.141.

Conclusión

En nuestro estudio, no se identificaron valores de DVNO capaces de diagnosticar el CFSC.

Palabras clave:
Ultrasonido
Nervio óptico
Muerte encefálica
Hipertensión intracraneal
Circulación cerebrovascular

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