使用视网膜动脉/静脉的比率来估计内压力
Mathias Just Nortvig1,2, Mikkel Christian Schou Andersen3,4, Niclas Lynge Eriksen3,4
1Department of Neurosurgery, Odense University Hospital, 5000, Odense, Denmark. mathias.just.nortvig@rsyd.dk.
Acta neurochirurgica
|November 8, 2024
概括
非侵入性脑后镜检查显示,通过分析动脉静脉 (A/V) 比率,有可能检测高内压 (ICP). 虽然有希望,但需要进一步的研究来提高诊断特异性和临床适用性.
科学领域:
- 眼科医生 眼科 眼科
- 神经学 神经学
- 医疗技术 医疗技术 医学技术
背景情况:
- 内压力 (ICP) 管理对于预防内病理患者的二次脑损伤至关重要.
- 目前的ICP监测方法具有侵入性,存在感染和出血的风险.
- 以前的研究表明,在门诊患者中,ICP与视网膜动脉静脉 (A/V) 比率之间存在相关性.
研究的目的:
- 调查后视镜在神经重症监护室 (NICU) 设置中的非侵入性ICP估计中的实用性.
- 评估A/V比率与ICP之间的相关性,包括眼内压力 (IOP).
主要方法:
- 一项前性队列研究,涉及成年患者,格拉斯哥昏迷表得分为8或以下的成年患者在NICU.
- 每日 fundoscopy 视频捕获和分析使用深度学习算法来计算 A/V 比率.
- 使用混合效应线性回归模型对A/V比率和ICP之间的相关性分析.
主要成果:
- 在A/V比率和ICP>15 mmHg之间观察到显著的负相关性 (p < 0.001).
- 对于ICP≤15 mmHg,没有发现显著的A/V比率变化.
- 纳入IOP的模型没有改善ICP估计;灵敏度为80.08%,特异性为22.51% (AUC:0.6389).
结论:
- 非侵入性脑膜扫描有潜力检测升高的ICP,与先前的发现保持一致.
- 图像质量和诊断特异性的挑战需要进一步调查.
- 更大的,多中心的研究和标准化是必要的,以验证和提高临床适用性.
相关概念视频
01:21Sites for measuring blood pressure
Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:30Equipments Used To Measure Blood Pressure
Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:15Assessment of blood pressure in brachial artery(one-step method)
This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure:
Prepare for the Procedure:
01:23Assessment of blood pressure in brachial artery(two-step method)
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
01:24Blood Pressure
The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.