Correlation between optic nerve sheath diameter measured by bedside ultrasound and intracranial pressure in neurologically ill patients in a Chinese population.

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Xiuli Zhang, Dandan Ma, Wenqiang Li, Jinluan Ma, Kexia Bi, Yuling Qiao, Zhen Li
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Abstract

Background: We assessed the correlation between optic nerve sheath diameter (ONSD) values measured by bedside ultrasound and intracranial pressure (ICP) changes among patients under neurocritical care and evaluated the diagnostic performance of ONSD for increased ICP.

Methods: Sixty-seven neurologically critical patients who were hospitalised in the intensive care unit (ICU) of Jining No.1 People's Hospital between September 2023 and March 2024 and underwent lumbar puncture were included. The ONSD was measured and recorded using bedside ultrasound before the lumbar puncture. Patients were divided into normal and increased ICP groups on the basis of the initial lumbar puncture pressure on admission, and both groups were compared. Spearman's correlation analysis was used for evaluating the correlation between ONSD values and ICP. Receiver operating characteristic (ROC) curves were employed for evaluating the diagnostic performance of ONSD for increased ICP.

Result: At admission, the Glasgow Coma Scale scores of patients in the increased ICP group were significantly lower than those of patients in the normal ICP group (P < 0.05). The ONSD level of patients in the increased ICP group was significantly higher than that of patients in the normal ICP group (P < 0.05). Spearman's correlation analysis revealed that ONSD positively correlated with ICP among patients with severe neurological diseases (r = 0.777, P < 0.001). The area under the ROC curve when using ONSD for diagnosing lumbar puncture opening pressure ≥ 200 mmH2O was 0.896 (95% confidence interval, 0.817-0.974). When using ONSD ≥ 4.74 mm as the threshold for diagnosing lumbar puncture opening pressure ≥ 200 mmH2O, the sensitivity and specificity were 0.909 and 0.765, respectively.

Conclusion: In patients with critical neurological illness, ONSD measured using bedside ultrasound positively correlated with ICP. Increased ICP can be diagnosed for ONSD ≥ 4.74 mm. The ONSD value measured by bedside ultrasound can be used for evaluating ICP among patients with critical neurological illness.

中国人群中神经系统疾病患者床旁超声测量的视神经鞘直径与颅内压之间的相关性。
背景:我们评估了神经重症患者床旁超声测量的视神经鞘直径(ONSD)值与颅内压(ICP)变化的相关性,并评价了ONSD对ICP增高的诊断性能:方法:纳入2023年9月至2024年3月期间在济宁市第一人民医院重症监护室(ICU)住院并接受腰椎穿刺的67例神经重症患者。腰椎穿刺前使用床旁超声测量并记录 ONSD。根据入院时腰椎穿刺的初始压力将患者分为ICP正常组和ICP增高组,并对两组患者进行比较。斯皮尔曼相关分析用于评估 ONSD 值与 ICP 之间的相关性。采用接收者操作特征曲线(ROC)评估 ONSD 对 ICP 增高的诊断性能:入院时,ICP增高组患者的格拉斯哥昏迷量表评分明显低于ICP正常组患者(P 2O 为 0.896(95% 置信区间,0.817-0.974))。以 ONSD≥4.74 mm 作为诊断腰椎穿刺开口压≥200 mmH2O 的阈值时,敏感性和特异性分别为 0.909 和 0.765:在神经系统重症患者中,床旁超声测量的ONSD与ICP呈正相关。ONSD≥4.74毫米可诊断为ICP增高。床旁超声测量的 ONSD 值可用于评估神经系统重症患者的 ICP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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