Using Optic Nerve Sheath Diameter for Intracranial Pressure (ICP) Monitoring in Traumatic Brain Injury: A Scoping Review
Karol Martínez-Palacios, Sebastián Vásquez-García, Olubunmi A. Fariyike, Chiara Robba, Andrés M. Rubiano, the noninvasive ICP monitoring international consensus group, Fabio Silvio Taccone, Frank Rasulo, R Rafael Badenes, David Menon, Aarti Sarwal, D Danilo Cardim, Marek Czosnyka, Mohammad Hirzallah, Thomas Geeraerts, Pierre Bouzat, Piergiorgio Lochner, Marcel Aries, Yu Lin Wong, Yasser Abulhassan, Gene Sung, Hemanshu Prabhakar, Gentle Sunder Shrestha, Luis Bustamante, Manuel Jibaja, Juan Pinedo, Diana Sanchez, Julio Mijangos Mendez, Franly Vásquez, Dhaval Shukla, Getaw Worku, Abenezer Tirsit, B Indiradevi, Hamisi K. Shabani, Amos O. Adeleye, Thangaraj Munusamy, Amelia Ain, Wellingson Silva Paiva, Daniel Agustín Godoy, Sérgio Brasil, Chiara Robba, Andrés M. Rubiano, Sebastián Vásquez-García
Abstract
INTRODUCTION: Neuromonitoring represents a cornerstone in the comprehensive management of patients with traumatic brain injury (TBI), allowing for early detection of complications such as increased intracranial pressure (ICP) [1]. This has led to a search for noninvasive modalities that are reliable and deployable at bedside. Among these, ultrasonographic optic nerve sheath diameter (ONSD) measurement is a strong contender, estimating ICP by quantifying the distension of the optic nerve at higher ICP values. Thus, this scoping review seeks to describe the existing evidence for the use of ONSD in estimating ICP in adult TBI patients as compared to gold-standard invasive methods. MATERIALS AND METHODS: This review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, with a main search of PubMed and EMBASE. The search was limited to studies of adult patients with TBI published in any language between 2012 and 2022. Sixteen studies were included for analysis, with all studies conducted in high-income countries. RESULTS: All of the studies reviewed measured ONSD using the same probe frequency. In most studies, the marker position for ONSD measurement was initially 3 mm behind the globe, retina, or papilla. A few studies utilized additional parameters such as the ONSD/ETD (eyeball transverse diameter) ratio or ODE (optic disc elevation), which also exhibit high sensitivity and reliability. CONCLUSION: Overall, ONSD exhibits great test accuracy and has a strong, almost linear correlation with invasive methods. Thus, ONSD should be considered one of the most effective noninvasive techniques for ICP estimation in TBI patients.