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Open AccessArticle

Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

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Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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Students’ Scientific Society, Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(10), 3656; https://doi.org/10.3390/ijerph17103656
Received: 8 April 2020 / Revised: 20 May 2020 / Accepted: 21 May 2020 / Published: 22 May 2020
Sepsis-associated brain dysfunction (SABD) with increased intracranial pressure (ICP) is a complex pathology that can lead to unfavorable outcome. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is used for non-invasive assessment of ICP. We aimed to assess the role of ONSD as a SABD screening tool. This prospective preliminary study covered 10 septic shock patients (5 men; aged 65, IQR 50–78 years). ONSD was measured bilaterally from day 1 to 10 (n = 1), until discharge (n = 3) or death (n = 6). The upper limit for ONSD was set at 5.7 mm. Sequential organ failure assessment score was calculated on a daily basis as a surrogate formulti-organ failure due to sepsis in the study population. On day 1, the medians of right and left ONSD were 5.56 (IQR 5.35–6.30) mm and 5.68 (IQR 5.50–6.10) mm, respectively, and four subjects had bilaterally elevated ONSD. Forty-nine out of 80 total measurements performed (61%) exceeded 5.7 mm during the study period. We found no correlations between ONSD and sequential organ failure assessment (SOFA) during the study period (right: R = −0.13–0.63; left R = −0.24–0.63). ONSD measurement should be applied for screening of SABD cautiously. Further research is needed to investigate the exact role of this non-invasive method in the assessment of brain dysfunction in these patients. View Full-Text
Keywords: intracranial pressure; optic nerve sheath diameter; sepsis-associated brain dysfunction; septic shock; ultrasound intracranial pressure; optic nerve sheath diameter; sepsis-associated brain dysfunction; septic shock; ultrasound
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Czempik, P.F.; Gąsiorek, J.; Bąk, A.; Krzych, Ł.J. Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report. Int. J. Environ. Res. Public Health 2020, 17, 3656.

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