Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia.
10.4097/kjae.2014.67.4.240
- Author:
Ji Yeon KIM
1
;
Hong Gi MIN
;
Seung Il HA
;
Hye Won JEONG
;
Hyungseok SEO
;
Joung Uk KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. seohyungseok@gmail.com
- Publication Type:Original Article
- Keywords:
Carbon dioxide;
Hyperventilation;
Optic nerve sheath diameter;
Ultrasonography
- MeSH:
Anesthesia, General*;
Carbon Dioxide;
Humans;
Hyperventilation*;
Intracranial Pressure;
Optic Nerve*;
Ultrasonography
- From:Korean Journal of Anesthesiology
2014;67(4):240-245
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Rapid evaluation and management of intracranial pressure (ICP) can help to early detection of increased ICP and improve postoperative outcomes in neurocritically-ill patients. Sonographic measurement of optic nerve sheath diameter (ONSD) is a non-invasive method of evaluating increased intracranial pressure at the bedside. In the present study, we hypothesized that sonographic ONSD, as a surrogate of ICP change, can be dynamically changed in response to carbon dioxide change using short-term hyperventilation. METHODS: Fourteen patients were enrolled. During general anesthesia, end-tidal carbon dioxide concentration (ETCO2) was decreased from 40 mmHg to 30 mmHg within 10 minutes. ONSD, which was monitored continuously in the single sonographic plane, was repeatedly measured at 1 and 5 minutes with ETCO2 40 mmHg (time-point 1 and 2) and measured again at 1 and 5 minutes with ETCO2 30 mmHg (time-point 3 and 4). RESULTS: The mean +/- standard deviation of ONSD sequentially measured at four time-points were 5.0 +/- 0.5, 5.0 +/- 0.4, 3.8 +/- 0.6, and 4.0 +/- 0.4 mm, respectively. ONSD was significantly decreased at time-point 3 and 4, compared with 1 and 2 (P < 0.001). CONCLUSIONS: The ONSD was rapidly changed in response to ETCO2. This finding may support that ONSD may be beneficial to close ICP monitoring in response to CO2 change.
