Ocular Ultrasonography in Assessing Severity and Management of Increased Intracranial Pressure in Traumatic Brain Injury
试验速览
- 阶段
- 不适用
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Assessing the changes in the intracranial pressure
研究概览
简要总结
Raised intracranial pressure (ICP) is a common and life threatening condition especially in patients with traumatic brain injury.There are many methods for monitoring the increased (ICP) either invasive or non- invasive ,but the gold standard is invasive method. Optic nerve sheath ultrasonography provides a very promising bedside tool for detection of increased ICP. This study will monitor the dynamic changes of intracranial pressure by optic nerve sheath diameter (ONSD) in response to mannitol osmotherapy
详细描述
Traumatic brain injury is the main cause of increased intracranial pressure (ICP) in the intensive care .
There are multiple methods for monitoring the raised ICP either invasive or non-invasive.The gold standard is the invasive devices because it is more accurate and reliable .However ,it requires a surgical intervention which has many hazards such as (infection ,hemorrhage,malfunction ).
Optic nerve sheath ultrasonography is a promising bedside tool for detection of increased ICP. The optic nerve is surrounded by cerebro-spinal fluid ,thus if the circulation of cerebro-spinal fluid not blocked ,an increase in ICP will be transmitted through the subarachnoid space around the optic nerve within the nerve sheath especially the retro-bulbar segment.
The study will be conducted to monitor the dynamic changes of intracranial pressure by optic nerve sheath diameter (ONSD) in response to mannitol osmotherapy as a primary outcome and secondary to evaluate the efficacy of ONSD in assessing the severity of the disease
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
盲法说明
No masking
入排标准
- 年龄范围
- 21 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with traumatic brain injury
排除标准
- •Patients with history of optic neuritis
- •past history of eye trauma
- •patient with optic nerve trauma
- •patient with history of arachnoid cyst of the optic nerve
- •high myopic patients
- •patients with cavernous sius mass
研究组 & 干预措施
Optic nerve sheath diameter
The intracranial pressure will be measured by optic nerve sheath diameter while the patient in supine position with 30 -degree bed position .The linear probe in the two -dimensional mode will be placed gently on the upper eyelid without pressure .In linear horizontal orientation for both right and left optic nerve sheath will be measured
干预措施: Optic nerve sheath diameter (Diagnostic Test)
结局指标
主要结局
Assessing the changes in the intracranial pressure
时间窗: from 20 minutes before mannitol therapy (basal reading) till 48 hours after the end of mannitol infusion
It will be monitored and recorded the changes in intracranial pressure to the mannitol therapy .Basal (before mannitol therapy).20 minutes after the end of mannitol infusion ,2 hours ,6 hours,12 hours ,24 hours and 48 hours after the end of mannitol infusion
次要结局
- Assessing the changes in the mean arterial pressure(from 20 minutes before mannitol therapy(basal reading) till 48 hours after the end of mannitol infusion)
- Assessing the changes in the heart rate(from 20 minutes before mannitol therapy (basal reading ) till 48 hours after the end of mannitol infusion)
研究者
Abdelraouf Elsharkawy
Lecturer of anesthesia and surgical intensive care
Mansoura University Hospital