MONITORING OSMOTHERAPY IN TRAUMATIC BRAIN INJURY PATIENTS: CORRELATION BETWEEN ULTRASOUND ASSESSMENT OF OPTIC NERVE SHEATH DIAMETER AND COMPUTED TOMOGRAPHY SCAN

Amin, Salwa Omar Elkhattab; Adel Alkady, Galal; Elmorshedy, Hossam Mohammed Mohammed; Ibrahim, Waleed Abdallah

doi:10.21608/asmj.2021.205386

MONITORING OSMOTHERAPY IN TRAUMATIC BRAIN INJURY PATIENTS: CORRELATION BETWEEN ULTRASOUND ASSESSMENT OF OPTIC NERVE SHEATH DIAMETER AND COMPUTED TOMOGRAPHY SCAN

Document Type : Original Article

Authors

¹ Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Egypt.

² Department of Intensive Care, Belbis General Hospital, Egypt.

10.21608/asmj.2021.205386

Abstract

Background: Traumatic brain injury has been one of the leading causes of morbidity, disability and mortality across all ages, globally, more than 50 million individuals suffer from TBIs each year. In Egypt it poses a major public health problem, representing 17.2% of trauma patients. Intracranial pressure is a major predictor of neurological deterioration in patients with TBI and post-traumatic intracranial hypertension is being associated with poor neurological outcome.
Aim of the Work: To compare ultrasound assessment of optic nerve sheath diameter as a monitoring tool of adequacy of brain dehydration by osmotherapy in traumatic brain injury in comparison to the current standard of using brain CT.
Patients and Methods: This study is a Prospective Observational study was conducted on 30 participants. All patients were polytrauma after road traffic accident with traumatic brain injury and were recruited from intensive care unit in Ain Shams University Hospitals during the period of February 2021 to May 2021.
Results: There was highly statistically significant decrease in right ONSD and left ONSD before and after mannitol from day 1 to day 3. There was highly statistically significant decrease in brain edema from day 1 to day 3 after osmotherapy. There was highly statistically significant relation found between CT brain edema and right ONSD and left ONSD before and after mannitol administration in third day, as CT brain already positive in first and second day.
Conclusion: We concluded that ONSD could be used as a tool to evaluate the efficacy and successful treatment by dehydrating measures in cases of increased ICP and can be utilized as a tool for decision making and point-of-care utility.

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