Optic Nerve Sheath Diameter in Retrobulbar Ultrasound as a Surrogate Measure for Intracranial Pressure Before and After Non-invasive Strategies

Hospital Dr. Miguel Pérez Carreño

Status: Completed

Conditions: Optic Nerve Sheath Diameter; Intracranial Hypertension

Treatments: Diagnostic Test: optical nerve sheet diameter

Study type: Observational

Funder types: Other

Identifiers

NCT03634176

ABAY

Details and patient eligibility

About

Measurement of the diameter of the sheath of the optic nerve in patients hospitalized in intensive care, with increased intracranial pressure (> 20mmHg) as a substitute measure for diagnosis and follow-up before and after different non-invasive strategies.

Three groups were created in which, through strategies already proven and non-invasive (mannitol, hypertonic solution 7.5% NaCl, reverse trendelenburg) to decrease the intracranial pressure, the optic nerve diameter measurement was performed and simultaneously the investigators monitored intracranial pressure through an intraventricular catheter continuously to determine if both correspond

Enrollment: 90 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients (≥ 18 years old) with traumatic or non-traumatic elevated ICP (defined as greater than 20 mm Hg for at least 10min)
• Hospitalized in ICU
• Patients with ICP continuous measurement through an intraventricular catheter
• Respiratory rate maintained at 10-18 breaths/min to maintain the end tidal carbon dioxide partial pressure between 35 and 40 mmHg
• Peak airway pressure <35 cmH2O
• Positive end-expiratory pressure <5 cmH2O

Exclusion criteria

• Patients who had undergone cranial decompression surgery
• Patients with ocular pathology
• Patients who had previously undergone eye surgery

Trial design

90 participants in 3 patient groups

Group M

Description:

both optic nerve sheath diameter (the posterior 3mm of the papilla) before and after received 0.5gr/kg 20% mannitol

Treatment:

Diagnostic Test: optical nerve sheet diameter

Group H

Description:

both optic nerve sheath diameter (the posterior 3mm of the papilla) before and after received 1.5 ml/kg 7.5% NaCl solution

Treatment:

Diagnostic Test: optical nerve sheet diameter

Group P

Description:

both optic nerve sheath diameter (the posterior 3mm of the papilla) before and after patients were positioned on reverse Trendelenburg position 30 degrees higher than the feet

Treatment:

Diagnostic Test: optical nerve sheet diameter