nach oben

Child's Nervous System

Erschienen in:

04.12.2019 | Original Article

Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children

verfasst von: Soo-Bin Yoon, Sang-Hwan Ji, Young-Eun Jang, Ji-Hyun Lee, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim

Erschienen in: Child's Nervous System | Ausgabe 5/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Optic nerve sheath diameter has been used for measure of intracranial pressure. The aim of this study was to evaluate the effect of prone positioning with neck extension on intracranial pressure in infants undergoing craniosynostosis surgery and to determine precautions using optic nerve sheath diameter measurement.

Methods

We enrolled 30 infants who were scheduled for correction of craniosynostosis in which planning included the prone position with neck extension. Optic nerve sheath diameter (anterior/lateral transbulbar approach) was measured 5 times in each eyeball at the following time points: 15 min after intubation in supine position as the baseline value (supine 1); 10 min after final surgical position before skin incision (prone); and 10 min after returning to supine position at the conclusion of surgery (supine 2). Hemodynamic parameters, airway peak pressure, oxygen saturation, and E_TCO₂ were monitored. Data were analyzed using repeated-measures multivariate analysis of variance to evaluate the effect of different positions under anesthesia on changes in using optic nerve sheath diameter and P < 0.05 was considered to be statistically significant.

Results

There was no difference in optic nerve sheath diameter after prone position with neck extension in all the measure. After surgery, optic nerve sheath diameter was decreased compared with the preoperative baseline values (Rt anterior/lateral 5.6/5.5: 5.4/5.2; Lt anterior/lateral 5.6/5.5: 5.4/5.3, P < 0.05, respectively).

Conclusions

In conclusion, prone positioning with head extension did not further increase intracranial pressure, although the surgical procedure could reduce intracranial pressure in the immediate postoperative period in infants undergoing craniosynostosis surgery.

Hayward R, Gonsalez S (2005) How low can you go? Intracranial pressure, cerebral perfusion pressure, and respiratory obstruction in children with complex craniosynostosis. J Neurosurg 102(1 Suppl):16–22. https://doi.org/10.3171/ped.2005.102.1.0016 CrossRefPubMed

Thomas GP, Johnson D, Byren JC, Judge AD, Jayamohan J, Magdum SA, Richards PG, Wall SA (2015) The incidence of raised intracranial pressure in nonsyndromic sagittal craniosynostosis following primary surgery. J Neurosurg Pediatr 15(4):350–360. https://doi.org/10.3171/2014.11.PEDS1426 CrossRefPubMed

Thompson DN, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22(5):235–240. https://doi.org/10.1159/000120907 CrossRefPubMed

Mavrocordatos P, Bissonnette B, Ravussin P (2000) Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results. J Neurosurg Anesthesiol 12(1):10–14. https://doi.org/10.1097/00008506-200001000-00003 CrossRefPubMed

Roth C, Ferbert A, Deinsberger W, Kleffmann J, Kastner S, Godau J, Schuler M, Tryba M, Gehling M (2014) Does prone positioning increase intracranial pressure? A retrospective analysis of patients with acute brain injury and acute respiratory failure. Neurocrit Care 21(2):186–191. https://doi.org/10.1007/s12028-014-0004-x CrossRefPubMed

Shirodkar CG, Munta K, Rao SM, Mahesh MU (2015) Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging. Indian J Crit Care Med 19(8):466–470. https://doi.org/10.4103/0972-5229.162465 CrossRefPubMedPubMedCentral

Haredy M, Zuccoli G, Tamber M, Davis A, Nischal K, Goldstein JA (2018) Use of neuroimaging measurements of optic nerve sheath diameter to assess intracranial pressure in craniosynostosis. Childs Nerv Syst 34(5):939–946. https://doi.org/10.1007/s00381-018-3728-7 CrossRefPubMed

Hansen HC, Helmke K (1997) Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg 87(1):34–40. https://doi.org/10.3171/jns.1997.87.1.0034 CrossRefPubMed

Helmke K, Hansen HC (1996) Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension II. Patient study. Pediatr Radiol 26(10):706–710. https://doi.org/10.1007/bf01383384 CrossRefPubMed

10.

Girisgin AS, Kalkan E, Kocak S, Cander B, Gul M, Semiz M (2007) The role of optic nerve ultrasonography in the diagnosis of elevated intracranial pressure. Emerg Med J 24(4):251–254. https://doi.org/10.1136/emj.2006.040931 CrossRefPubMedPubMedCentral

11.

Kimberly HH, Shah S, Marill K, Noble V (2008) Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 15(2):201–204. https://doi.org/10.1111/j.1553-2712.2007.00031.x CrossRefPubMed

12.

Lin SD, Kahne KR, El Sherif A, Mennitt K, Kessler D, Ward MJ, Platt SL (2017) The use of ultrasound-measured optic nerve sheath diameter to predict ventriculoperitoneal shunt failure in children. Pediatr Emerg Care. https://doi.org/10.1097/PEC.0000000000001034

13.

Padayachy LC, Padayachy V, Galal U, Gray R, Fieggen AG (2016) The relationship between transorbital ultrasound measurement of the optic nerve sheath diameter (ONSD) and invasively measured ICP in children : Part I: repeatability, observer variability and general analysis. Childs Nerv Syst 32(10):1769–1778. https://doi.org/10.1007/s00381-016-3067-5 CrossRefPubMed

14.

Bauerle J, Lochner P, Kaps M, Nedelmann M (2012) Intra- and interobsever reliability of sonographic assessment of the optic nerve sheath diameter in healthy adults. J Neuroimaging 22(1):42–45. https://doi.org/10.1111/j.1552-6569.2010.00546.x CrossRefPubMed

15.

(2017) Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology 126(3):376–393. https://doi.org/10.1097/ALN.0000000000001452

16.

Hall MK, Spiro DM, Sabbaj A, Moore CL, Hopkins KL, Meckler GD (2013) Bedside optic nerve sheath diameter ultrasound for the evaluation of suspected pediatric ventriculoperitoneal shunt failure in the emergency department. Childs Nerv Syst 29(12):2275–2280. https://doi.org/10.1007/s00381-013-2172-y CrossRefPubMed

17.

Ballantyne J, Hollman AS, Hamilton R, Bradnam MS, Carachi R, Young DG, Dutton GN (1999) Transorbital optic nerve sheath ultrasonography in normal children. Clin Radiol 54(11):740–742. https://doi.org/10.1016/s0009-9260(99)91176-5 CrossRefPubMed

18.

Chin JH, Seo H, Lee EH, Lee J, Hong JH, Hwang JH, Kim YK (2015) Sonographic optic nerve sheath diameter as a surrogate measure for intracranial pressure in anesthetized patients in the Trendelenburg position. BMC Anesthesiol 15:43. https://doi.org/10.1186/s12871-015-0025-9 CrossRefPubMedPubMedCentral

19.

Tamburrini G, Caldarelli M, Massimi L, Santini P, Di Rocco C (2005) Intracranial pressure monitoring in children with single suture and complex craniosynostosis: a review. Childs Nerv Syst 21(10):913–921. https://doi.org/10.1007/s00381-004-1117-x CrossRefPubMed

20.

Taylor WJ, Hayward RD, Lasjaunias P, Britto JA, Thompson DN, Jones BM, Evans RD (2001) Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage. J Neurosurg 94(3):377–385. https://doi.org/10.3171/jns.2001.94.3.0377 CrossRefPubMed

21.

Mundinger GS, Skladman R, Wenger T, Birgfeld CC, Gruss JS, Lee A, Ellenbogen R, Hopper RA (2018) Defining and correcting asymmetry in isolated unilateral frontosphenoidal synostosis: differences in orbital shape, facial scoliosis, and skullbase twist compared to unilateral coronal synostosis. J Craniofac Surg 29(1):29–35. https://doi.org/10.1097/SCS.0000000000004052 CrossRefPubMed

22.

Newman WD, Hollman AS, Dutton GN, Carachi R (2002) Measurement of optic nerve sheath diameter by ultrasound: a means of detecting acute raised intracranial pressure in hydrocephalus. Br J Ophthalmol 86(10):1109–1113. https://doi.org/10.1136/bjo.86.10.1109 CrossRefPubMedPubMedCentral

23.

Thompson DN, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R (1995) Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst 11(5):269–275. https://doi.org/10.1007/bf00301758 CrossRefPubMed

24.

Robba C, Bragazzi NL, Bertuccio A, Cardim D, Donnelly J, Sekhon M, Lavinio A, Duane D, Burnstein R, Matta B, Bacigaluppi S, Lattuada M, Czosnyka M (2017) Effects of prone position and positive end-expiratory pressure on noninvasive estimators of ICP: a pilot study. J Neurosurg Anesthesiol 29(3):243–250. https://doi.org/10.1097/ANA.0000000000000295 CrossRefPubMed

25.

Petersen LG, Ogoh S (2019) Gravity, intracranial pressure, and cerebral autoregulation. Physiol Rep 7(6):e14039. https://doi.org/10.14814/phy2.14039 CrossRefPubMedPubMedCentral

26.

Tuite GF, Chong WK, Evanson J, Narita A, Taylor D, Harkness WF, Jones BM, Hayward RD (1996) The effectiveness of papilledema as an indicator of raised intracranial pressure in children with craniosynostosis. Neurosurgery 38(2):272–278CrossRef

27.

Sujata N, Tobin R, Tamhankar A, Gautam G, Yatoo AH (2019) A randomised trial to compare the increase in intracranial pressure as correlated with the optic nerve sheath diameter during propofol versus sevoflurane-maintained anesthesia in robot-assisted laparoscopic pelvic surgery. J Robot Surg 13(2):267–273. https://doi.org/10.1007/s11701-018-0849-7 CrossRefPubMed

28.

Agrawal A, Cheng R, Tang J, Madhok DY (2019) Comparison of two techniques to measure optic nerve sheath diameter in patients at risk for increased intracranial pressure. Crit Care Med. https://doi.org/10.1097/CCM.0000000000003742

29.

Christian EA, Imahiyerobo TA, Nallapa S, Urata M, McComb JG, Krieger MD (2015) Intracranial hypertension after surgical correction for craniosynostosis: a systematic review. Neurosurg Focus 38(5):E6. https://doi.org/10.3171/2015.2.FOCUS14853 CrossRefPubMed

30.

Grandhi R, Peitz GW, Foley LM, Bonfield CM, Fellows-Mayle W, Hitchens TK, Mooney MP (2018) The influence of suturectomy on age-related changes in cerebral blood flow in rabbits with familial bicoronal suture craniosynostosis: a quantitative analysis. PLoS One 13(6):e0197296. https://doi.org/10.1371/journal.pone.0197296 CrossRefPubMedPubMedCentral

Titel: Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children
verfasst von: Soo-Bin Yoon
Sang-Hwan Ji
Young-Eun Jang
Ji-Hyun Lee
Eun-Hee Kim
Jin-Tae Kim
Hee-Soo Kim
Publikationsdatum: 04.12.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 5/2020
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04442-3

Neu im Fachgebiet Chirurgie

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | HNO-Chirurgie | Nachrichten

HNO-Op. auch mit über 90?

16.04.2024 | Infektiologie | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Effects of prone positioning with neck extension on intracranial pressure according to optic nerve sheath diameter measured using ultrasound in children

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Chirurgie

Hochrisiko-Eingriffe für postoperative Übelkeit

HNO-Op. auch mit über 90?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2020

Clinical prediction models

Penetrating traumatic brain injury resulting from a cockerel attack: case report and literature review

Ultrasound evaluation of optic nerve sheath diameter to assess treatment efficacy in pediatric idiopathic intracranial hypertension

Systematic review of spinal deformities following multi-level selective dorsal rhizotomy

Transcranial Doppler ultrasound findings in children with moderate-to-severe traumatic brain injury following abusive head trauma

Aborting a neurosurgical procedure: analyzing the decision factors, with endoscopic third ventriculostomy as a model

Neu im Fachgebiet Chirurgie

Hochrisiko-Eingriffe für postoperative Übelkeit

HNO-Op. auch mit über 90?

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“