Prediction of intracranial pressure from noninvasive transocular venous and arterial hemodynamic measurements: a pilot study
| Autor: | Steven W Arms, Thorsten Steiner, Henry W. Querfurth, Christoph Lichy, William T Irwin |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Central retinal vein Intracranial Pressure Retinal Artery Point-of-Care Systems Pilot Projects Critical Care and Intensive Care Medicine Ophthalmic Artery Cerebrospinal fluid Predictive Value of Tests Internal medicine Intensive care Occlusion Medicine Humans Ultrasonography Doppler Color Vein Intracranial pressure Aged Monitoring Physiologic Brain Diseases integumentary system medicine.diagnostic_test business.industry Lumbar puncture musculoskeletal neural and ocular physiology Middle Aged nervous system diseases medicine.anatomical_structure Anesthesia Cardiology Optic nerve Feasibility Studies Ophthalmodynamometry Female Neurology (clinical) business Venous Pressure Blood Flow Velocity |
| Zdroj: | Neurocritical care. 1(2) |
| ISSN: | 1541-6933 |
| Popis: | Introduction: Continuous measurement of intracranial pressure (ICP) requires the invasive placement of epidural, parenchymal, or intraventricular devices. For critical single-point assessments, lumbar puncture may not always be practical. An accurate, reliable, portable and noninvasive method to estimate absolute ICP remains an elusive goal. The arteries that perfuse and the vein that drains the orbit are exposed to the ambient ICP while coursing through the cerebrospinal fluid or optic nerve. Methods: The venous outflow pressure (VOP) of the central retinal vein was measured using occlusion in six intensive care patients treated for acute hydrocephalus or brain hemorrhage and in whom transducers of intracranial pressure could provide standardized continuous output. A novel adaptation of the Balliart ophthalmodynamometer was developed for use. Simultaneously, the central retinal (CRA) and ophthalmic (OA) arterial flow velocities were recorded using color Doppler imaging technique. Repeat noninvasive measurements were performed at various ICPs, (n=22 independently collected observations). Linear regression and correlation testing were performed to evaluate these variables for ICP predictability. Results: The VOP increased linearly with ICP (r=0.87). The arterial pulsatility indices for both OA and CRA decreased inversely with ICP (r=0.66). An empiric index combining both venous and arterial parameters (VOP/Gosling Pulsatility Index [GPI]) was significantly more correlated with absolute ICP than either parameter alone (r=0.95, p |
| Databáze: | OpenAIRE |
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