Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Neurology, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Division of Pediatric Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Biomed J. 2020 Jun;43(3):231-239. doi: 10.1016/j.bj.2020.04.006. Epub 2020 Apr 23.
The rapid diagnosis of increased intracranial pressure is urgently needed for therapeutic reasons in neurocritically ill children, however this can rarely be achieved without invasive procedures. Point-of-care ultrasound of the optic nerve sheath diameter has been proposed as a non-invasive and reliable means to detect increased intracranial pressure in adults. Accordingly, clinicians may be able to use this technique to initiate early treatment and monitor the effectiveness of treatment in conjunction with other clinical examination and diagnostic modalities. Two meta-analyses and a systematic review have been published on this topic in adults. However, data on the correlation between optic nerve sheath diameter and intracranial pressure in neurocritically ill children are scarce. The aim of this review was to briefly describe what is being measured with point-of-care ultrasound of the optic nerve sheath diameter, summarize the most recent findings from adult literature, and provide an update of current work in children.
神经危重症患儿急需进行快速颅内压诊断，以采取治疗措施，但在无有创操作的情况下，这很难实现。视神经鞘直径的即时床旁超声检查被提议作为一种非侵入性和可靠的方法，用于检测成人颅内压升高。因此，临床医生可能能够使用该技术来启动早期治疗，并结合其他临床检查和诊断方式来监测治疗效果。已有两项关于成人的荟萃分析和系统评价针对该主题进行了发表。然而，神经危重症患儿视神经鞘直径与颅内压之间相关性的数据却很匮乏。本综述旨在简要描述即时床旁视神经鞘直径超声检查所测量的内容，总结成人文献的最新发现，并提供儿童领域目前工作的最新进展。
