REVIEW   Free access

Minerva Anestesiologica 2019 September;85(9):995-1002

DOI: 10.23736/S0375-9393.19.13437-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Role of automated pupillometry in critically ill patients

Paola MORELLI, Mauro ODDO, Nawfel BEN-HAMOUDA ✉

Department of Intensive Care and Burns, Lausanne University Hospital (CHUV), Lausanne, Switzerland

Pupillary examination has fundamental diagnostic and prognostic values in clinical practice. However, pupillary assessment was relied until present on manual, qualitative, examination, using manual flash penlights or lamps. Quantitative examination with the use of automated infrared video-pupillometers allows an objective assessment of several pupillary parameters and may be superior to manual subjective examination. The potential for quantitative pupillometry is multiple in the setting of critical care, for the monitoring and detection of secondary cerebral insults and to assess brainstem dysfunction and early coma outcome prognostication, and in the intra-operative anesthesiology setting, to assess analgesia and opioid requirement. Here, we describe the pupillometry technique and review recent critical care and anesthesiology studies that demonstrate the value and potential clinical utility of quantitative pupillometry as neuromonitoring bedside modality.

KEY WORDS: Brain injuries; Pupil; Neurophysiological monitoring