1. Effect of Percutaneous Tracheostomy on Optic Nerve Sheath Diameter [TONS Trial]
- Author
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Indu Kapoor, Subodh Kumar, Hirok Roy, Vasudha Singhal, Arvind Chaturvedi, Charu Mahajan, Rupali Brahma, Mani Kalaivani, Jaya Wanchoo, Hemanshu Prabhakar, and Chandrakant Prasad
- Subjects
Optic nerve sheath ,Intracranial pressure ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,parasitic diseases ,Optic nerve sheath diameter ,medicine ,Neurocritical care ,Bedside ultrasound ,Original Research ,Skin incision ,integumentary system ,business.industry ,musculoskeletal, neural, and ocular physiology ,Neurointensive care ,030208 emergency & critical care medicine ,humanities ,nervous system diseases ,Percutaneous tracheostomy ,030228 respiratory system ,ON - Optic nerve ,Airway management ,Nuclear medicine ,business ,Neurocritically ill ,hormones, hormone substitutes, and hormone antagonists - Abstract
Highlights Like any other surgical procedures, PCT procedure can cause fluctuation in ICP in neurocritically ill patients. Noninvasive ICP monitoring by measuring ONSD using bedside ultrasound would be very helpful in these patients who do not have invasive ICP catheter in situ due to nonavailability, institutional protocol, or any other reason. Measuring ONSD in neurocritically ill patients undergoing PCT procedure would help clinicians for early recognition and management of raised ICP, which would further add on to the overall outcome of the patient., Background Elective percutaneous tracheostomy [PCT] is the widely performed procedure in neurocritically ill patients as an airway management choice in neurocritical care unit [NICU]. Intracranial pressure [ICP] is a vital parameter to be monitored in these patients while undergoing any surgical procedure including PCT. Optic nerve sheath diameter [ONSD], being a surrogate of ICP, can be done bedside and carries less complications than invasive ICP monitoring. The aim of our study was to assess the effect of PCT on ONSD at different stages of PCT. Materials and methods A total of 158 patients with various intracranial pathologies scheduled for PCT in NICU were screened for eligibility in our study. We assessed mean values of ONSD, HR, MBP, and SpO2 for changes over various time points during PCT using generalized estimating equation (GEE). A p value of
- Published
- 2021