Dynamic optic nerve sheath diameter responses to short-term hyperventilation measured with sonography in patients under general anesthesia
Korean Journal of Anesthesiology 2014³â 67±Ç 4È£ p.240 ~ p.245
±èÁö¿¬(Kim Ji-Yeon) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
¹ÎÈ«±â(Min Hong-Gi) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
ÇϽÂÀÏ(Ha Seung-Il) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
Á¤Çý¿ø(Jeong Hye-Won) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
¼Çü¼®(Seo Hyung-Seok) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
±èÁ¤¿í(Kim Joung-Uk) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
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 ¡¾ standard deviation of ONSD sequentially measured at four time-points were 5.0 ¡¾ 0.5, 5.0 ¡¾ 0.4, 3.8 ¡¾ 0.6, and 4.0 ¡¾ 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.
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Carbon dioxide, Hyperventilation, Optic nerve sheath diameter, Ultrasonography
KMID :
0356920140670040240
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