Dynamic optic nerve sheath diameter changes upon moderate hyperventilation in patients with traumatic brain injury

Area of Science:

• Neurosonography
• Intensive Care Medicine
• Trauma Surgery

Background:

• Sonographic assessment of optical nerve sheath diameter (ONSD) offers non-invasive intracranial pressure (ICP) monitoring.
• Hyperventilation (HV)-induced hypocapnia is a strategy to reduce ICP in traumatic brain injury (TBI) patients.
• The reliability of sonography in detecting dynamic ONSD changes during HV requires investigation.

Purpose of the Study:

• To investigate if sonography is a reliable tool for detecting dynamic changes in ONSD.
• To assess the correlation between HV and ONSD variations in TBI patients.

Main Methods:

• Prospective single-center trial involving TBI patients with neuromonitoring.
• ONSD measurements taken at baseline and during 50 minutes of moderate HV.
• Control group of non-TBI patients recruited for comparison.

Main Results:

• Ten TBI patients (mean age 35 ± 14 years) and ten controls were included.
• Significant ICP decrease observed in the TBI group during HV (p < .0001).
• A statistically significant ONSD response to HV was detected (p = .05).

Conclusions:

• A dynamic decrease in ONSD was observed during moderate HV.
• Serial ONSD measurements show potential utility in managing suspected intracranial hypertension with HV.
• Sonography provides a non-invasive method to monitor ICP changes during HV in TBI.