Non-invasive Intracranial Pressure Assessment in Brain Injured Patients Using Ultrasound-Based Methods

Acta Neurochirurgica. Supplement
Chiara RobbaMarek Czosnyka

Abstract

Non-invasive measurement of intracranial pressure (ICP) can be invaluable in the management of critically ill patients. Invasive measurement of ICP remains the "gold standard" and should be performed when clinical indications are met, but it is invasive and brings some risks. In this project, we aim to validate the non-invasive ICP (nICP) assessment models based on arterious and venous transcranial Doppler ultrasonography (TCD) and optic nerve sheath diameter (ONSD). We included brain injured patients requiring invasive ICP monitoring (intraparenchymal or intraventricular). We assessed the concordance between ICP measured non-invasively with arterious [flow velocity diastolic formula (ICPFVd) and pulsatility index (PI)], venous TCD (vPI) and ICP derived from ONSD (nICPONSD) compared to invasive ICP measurement. Linear regression showed a positive relationship between nICP and ICP for all the methods, except PIv. ICPONSD showed the strongest correlation with invasive ICP (r = 0.61) compared to the other methods (ICPFVd, r = 0.26, p value = 0.0015; PI, r = 0.19, p value = 0.02, vPI, r = 0.056, p value = 0.510). The ability to predict intracranial hypertension was highest for ICPONSD (AUC = 0.91; 95% CI, 0.85-0.97 at ICP > 20 mmHg...Continue Reading

Associated Clinical Trials

Citations

Nov 22, 2018·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Piergiorgio LochnerRobert Lemor
Jan 23, 2019·JAMA Neurology·Katharina Maria BuslPanayiotis N Varelas
Jan 11, 2020·Minerva anestesiologica·Rita BertuettiChiara Robba
Apr 3, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Vilakshan AlambyanCiro Ramos-Estebanez
Jan 4, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Tolga F Köroğlu
Mar 25, 2020·Critical Care : the Official Journal of the Critical Care Forum·Frank A RasuloStefano Romagnoli
Jun 27, 2019·Minerva anestesiologica·Anselmo Caricato, Camilla Gelormini
Jun 25, 2020·Fluids and Barriers of the CNS·Nicolas CanacRobert B Hamilton
Mar 30, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Brasil Chian Ping JengWellingson Silva Paiva

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