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

• Published in: International journal of environmental research and public health 2020-05, Vol.17 (10), p.3656
• Main Authors: Czempik, Piotr F, Gąsiorek, Jakub, Bąk, Aleksandra, Krzych, Łukasz J
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia; Biomarkers; Blood-brain barrier; Brain; Brain - physiopathology; Brain Diseases - etiology; Coma; Correlation analysis; Edema; Humans; Hypertension; Infections; Intracranial Pressure; Laboratories; Male; Metabolism; Middle Aged; Mortality; Nervous system; Optic nerve; Optic Nerve - anatomy & histology; Optic Nerve - diagnostic imaging; Physiology; Population; Population studies; Prospective Studies; Sensitivity and Specificity; Sepsis; Sepsis - complications; Septic shock; Sheaths; Traumatic brain injury; Ultrasonic imaging; Ultrasonics; Ultrasonography; Ventilators
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17103656

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 ( = 1), until discharge ( = 3) or death ( = 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.