Point-of-care ultrasound of optic nerve sheath diameter to detect intracranial pressure in neurocritically ill children - A narrative review

Jainn-Jim Lin; Aaron E Chen; Elaina E Lin; Shao-Hsuan Hsia; Ming-Chou Chiang; Kuang-Lin Lin

doi:10.1016/j.bj.2020.04.006

Point-of-care ultrasound of optic nerve sheath diameter to detect intracranial pressure in neurocritically ill children - A narrative review

Biomed J. 2020 Jun;43(3):231-239. doi: 10.1016/j.bj.2020.04.006. Epub 2020 Apr 23.

Authors

Jainn-Jim Lin¹, Aaron E Chen², Elaina E Lin³, Shao-Hsuan Hsia⁴, Ming-Chou Chiang⁵, Kuang-Lin Lin⁶

Affiliations

¹ Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Neurology, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
² Division of Pediatric Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Neonatology, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁶ Division of Pediatric Neurology, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: lincgh@adm.cgmh.org.tw.

Abstract

The rapid diagnosis of increased intracranial pressure is urgently needed for therapeutic reasons in neurocritically ill children, however this can rarely be achieved without invasive procedures. Point-of-care ultrasound of the optic nerve sheath diameter has been proposed as a non-invasive and reliable means to detect increased intracranial pressure in adults. Accordingly, clinicians may be able to use this technique to initiate early treatment and monitor the effectiveness of treatment in conjunction with other clinical examination and diagnostic modalities. Two meta-analyses and a systematic review have been published on this topic in adults. However, data on the correlation between optic nerve sheath diameter and intracranial pressure in neurocritically ill children are scarce. The aim of this review was to briefly describe what is being measured with point-of-care ultrasound of the optic nerve sheath diameter, summarize the most recent findings from adult literature, and provide an update of current work in children.

Keywords: Intracranial pressure; Optic nerve sheath diameter; Pediatric neurocritical care unit; Point-of-care ultrasound.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Case-Control Studies
Humans
Intracranial Pressure*
Optic Nerve / diagnostic imaging
Point-of-Care Systems*
Retrospective Studies
Ultrasonography