■高颅内压(ICP)是中枢神经系统(CNS)感染最常见的并发症之一。未能控制高颅内压导致脑疝和死亡。高ICP的治疗之一涉及以3%NaCl或20%甘露醇的形式施用渗透疗法,并在施用期间观察。通过测量视神经鞘直径(ONSD)可以在渗透治疗期间观察ICP,这可能与意识程度相关,瞳孔直径,和光反射。以前的研究没有将ONSD与意识程度相关联,瞳孔直径,渗透治疗期间的光反射。
■通过将其与意识程度相关联,提供将ONSD测量作为一种非侵入性床旁方法进行ICP监测的见解,瞳孔直径,和光反射在几个时间点。
■这项研究是一项前瞻性队列研究,在万隆中央总医院HasanSadikin博士进行,Cibabat总地区医院,万隆基瓦里总地区医院对2-18岁意识下降和中枢神经系统感染的儿童,2023年6月以0.90的相关系数进行评分者间的可靠性。测量ONSD,意识程度,瞳孔直径,在30例患者开始渗透治疗后48小时内同时进行光反射。使用Spearman排名进行相关分析。
■施用渗透治疗后48小时的观察显示ONSD的变化。ONSD与意识程度呈显著正相关(右眼r=0.621,左眼r=0.602,p<0.001)。发现ONSD与光反射之间存在显着正相关(右眼r=0.801,左眼r=0.812,p<0.001)。与瞳孔直径变化无显著相关性(右眼r=-0.136,左眼r=-0.141,p>0.05)。
■在渗透治疗期间,2-18岁的中枢神经系统感染儿童的ONSD与意识和光反射程度之间存在显着相关性。
UNASSIGNED: High intracranial pressure (ICP) is one of the most common complications of central nervous system (CNS) infection. Failure to control high intracranial pressure results in brain herniation and death. One of the treatments for high ICP involves the administration of
osmotherapy in the form of 3% NaCl or 20% mannitol with observation during administration. Observation of ICP during administration of
osmotherapy is possible through measurement of optic nerve sheath diameter (ONSD), which could be correlated with degree of consciousness, pupil diameter, and light reflex. Previous studies have not correlated ONSD with degree of consciousness, pupil diameter, and light reflex during the administration of osmotherapy.
UNASSIGNED: To provide insights of incorporating ONSD measurement as a form of non-invasive bedside method for ICP monitoring by correlating it with degree of consciousness, pupil diameter, and light reflex at several time points.
UNASSIGNED: This study is a prospective cohort study, performed at Dr. Hasan Sadikin General Central Hospital Bandung, Cibabat General Regional Hospital, and General Regional Hospital Bandung Kiwari on children aged 2-18 years with decreased consciousness and CNS infection, from June 2023. Inter-rater reliability was performed with a correlation coefficient of 0.90. Measurement of ONSD, degree of consciousness, pupil diameter, and light reflex simultaneously up to 48 h after initiation of
osmotherapy to 30 patients. Correlational analyses were performed using Spearman\'s rank.
UNASSIGNED: Observation for 48 h after administration of
osmotherapy showed changes in ONSD. A significant positive correlation was found between ONSD and degree of consciousness (r = 0.621 for the right eye and r = 0.602 for the left eye, p < 0.001). A significant positive correlation was found between ONSD and light reflex (r = 0.801 for the right eye and r = 0.812 for the left eye, p < 0.001). No significant correlation was found with changes of pupil diameter (r = -0.136 for the right eye and r = -0.141 for the left eye, p > 0.05).
UNASSIGNED: A significant correlation was found between ONSD and degree of consciousness and light reflex in children aged 2-18 years with CNS infection during administration of
osmotherapy.