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. 2024 Jun;40(3):1193-1212.
doi: 10.1007/s12028-023-01884-1. Epub 2023 Dec 19.

Using Optic Nerve Sheath Diameter for Intracranial Pressure (ICP) Monitoring in Traumatic Brain Injury: A Scoping Review

Karol Martínez-Palacios  1   2 , Sebastián Vásquez-García  2   3 , Olubunmi A Fariyike  2   4 , Chiara Robba  5 , Andrés M Rubiano  6   7 ; noninvasive ICP monitoring international consensus group
Collaborators, Affiliations

Using Optic Nerve Sheath Diameter for Intracranial Pressure (ICP) Monitoring in Traumatic Brain Injury: A Scoping Review

Karol Martínez-Palacios et al. Neurocrit Care. 2024 Jun.

Abstract

Introduction: Neuromonitoring represents a cornerstone in the comprehensive management of patients with traumatic brain injury (TBI), allowing for early detection of complications such as increased intracranial pressure (ICP) [1]. This has led to a search for noninvasive modalities that are reliable and deployable at bedside. Among these, ultrasonographic optic nerve sheath diameter (ONSD) measurement is a strong contender, estimating ICP by quantifying the distension of the optic nerve at higher ICP values. Thus, this scoping review seeks to describe the existing evidence for the use of ONSD in estimating ICP in adult TBI patients as compared to gold-standard invasive methods.

Materials and methods: This review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, with a main search of PubMed and EMBASE. The search was limited to studies of adult patients with TBI published in any language between 2012 and 2022. Sixteen studies were included for analysis, with all studies conducted in high-income countries.

Results: All of the studies reviewed measured ONSD using the same probe frequency. In most studies, the marker position for ONSD measurement was initially 3 mm behind the globe, retina, or papilla. A few studies utilized additional parameters such as the ONSD/ETD (eyeball transverse diameter) ratio or ODE (optic disc elevation), which also exhibit high sensitivity and reliability.

Conclusion: Overall, ONSD exhibits great test accuracy and has a strong, almost linear correlation with invasive methods. Thus, ONSD should be considered one of the most effective noninvasive techniques for ICP estimation in TBI patients.

Keywords: Intracranial hypertension; Intracranial pressure (ICP); Invasive monitoring; Monitoring; Noninvasive monitoring; Optic nerve sheath diameter; Optic nerve ultrasound; Traumatic brain injury (TBI).

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Conflict of interest statement

There are no conflicts of interest to report in this project.

Figures

Fig. 1
Fig. 1
Extraction methodology
Fig. 2
Fig. 2
Characteristics of included publications
See this image and copyright information in PMC

References

    1. Evensen KB, Eide PK. Measuring intracranial pressure by invasive, less invasive or non-invasive means: limitations and avenues for improvement. Fluids Barriers CNS. 2020;17(1):34. doi: 10.1186/s12987-020-00195-3. - DOI - PMC - PubMed
    1. Carney N, Totten AM, O’Reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 2017;80(1). 10.1227/NEU.0000000000001432. - PubMed
    1. Vik A, Nag T, Fredriksli OA, et al. Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg. 2008;109(4):678–684. doi: 10.3171/JNS/2008/109/10/0678. - DOI - PubMed
    1. Chesnut RM, Temkin N, Carney N, et al. A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med. 2012;367(26):2471–2481. doi: 10.1056/NEJMoa1207363. - DOI - PMC - PubMed
    1. Robba C, Graziano F, Rebora P, et al. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. Lancet Neurol. 2021;20(7):548–558. doi: 10.1016/S1474-4422(21)00138-1. - DOI - PubMed

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