Cukurova University, Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey.
Cukurova University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Turkey.
Early Hum Dev. 2020 Jun;145:104986. doi: 10.1016/j.earlhumdev.2020.104986. Epub 2020 Apr 23.
Bedside sonographic opthalmic ultrasound measurement of optic nerve sheath diameter (ONSD) is an easy, portabl, noninvasive and a radiation free technique to determine increased intracranial pressure. This prospective, multicenter study was aimed to establish the range of normal values for ONSD in preterm and term newborns with a large study population.
Newborns without intracranial pathology in the Newborn Intensive Care Units and in Obstetrics and Gynecology Departments were enrolled in the study. ONSD was measured at 3 mm distance behind of the right optic nerve head. As 3 mm distance was beyond the optic nerve head in some of the premature newborns, we had also measurements at 2 and 2.5 mm.
ONSD was measured in 554 newborns. Mean ONSD of preterm babies at 2, 2.5 and 3 mm distances were 3.2 ± 0.3 mm (range 2.0-4.2 mm), 3.3 ± 0.3 mm (range 2.2-4.5 mm) and 3.6 ± 0.2 mm (range 2.9-4.5 mm), (p < 0.001, p < 0.001, p < 0.001) respectively. Mean ONSD of term babies at 3 mm was higher than the mean ONSD of preterm babies in 33 weeks 0 day- 37 weeks 0 days group (p < 0.001). In correlation analysis, a significant, strong and positive correlation was found between ONSD measurements and gestational age, weight, height and head circumference at 2, 2.5 and 3 mm distances.
The normal values reported by the present study may be used for evaluating the ONSD of newborns with different conditions with increased incracranial pressure.
通过床边超声测量视神经鞘直径（ONSD）是一种简单、便携、无创且无辐射的技术，可用于确定颅内压升高。本前瞻性多中心研究旨在建立大样本早产儿和足月新生儿的 ONSD 正常参考值范围。
本研究纳入了新生儿重症监护病房和妇产科无颅内病变的新生儿。在右侧视神经头后 3mm 处测量 ONSD。由于一些早产儿的视神经头后 3mm 处无法测量，我们还在 2mm 和 2.5mm 处进行了测量。
共测量了 554 名新生儿的 ONSD。早产儿在 2mm、2.5mm 和 3mm 处的平均 ONSD 分别为 3.2±0.3mm（范围 2.0-4.2mm）、3.3±0.3mm（范围 2.2-4.5mm）和 3.6±0.2mm（范围 2.9-4.5mm）（p<0.001，p<0.001，p<0.001）。足月新生儿在 3mm 处的平均 ONSD 高于 33 周 0 天-37 周 0 天组早产儿（p<0.001）。在相关分析中，在 2mm、2.5mm 和 3mm 处，ONSD 测量值与胎龄、体重、身高和头围之间存在显著、强且正相关。
本研究报道的正常值可用于评估不同情况下颅内压升高的新生儿的 ONSD。
