NDLI: A study to evaluate effect of PEEP and end-tidal carbon dioxide on optic nerve sheath diameter

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A study to evaluate effect of PEEP and end-tidal carbon dioxide on optic nerve sheath diameter

Content Provider	Scilit
Author	Bala, Renu Kumar, Rajesh Sharma, Jyoti
Copyright Year	2019
Abstract	Background and Aims: PEEP is commonly used to improve postoperative respiratory outcomes in surgical and ICU patients. It is thought to increase ICP by impending CSF outflow and cerebral venous drainage. Hyperventilation is used to decrease ICP in patients having intracranial hypertension. We investigated the effect of various levels of PEEP and $EtCO_{2}$ on ONSD as an indirect predictor of ICP in patients undergoing surgery under GA. Methods: After induction, different levels of PEEP and $EtCO_{2}$ were applied to 50patients. Sonographic ONSD was measured 5minutes after stabilization of each new setting. Haemodynamic parameters like pulse, $SpO_{2}$, BP were also recorded. Quantitative variables were expressed as Mean±SD and compared across between follow-ups using paired t-test. Qualitative variables were expressed in number and percentage. Results: Baseline ONSD was 0.44±0.06cm. It increased significantly to 0.45±0.07cm, 0.47±0.07cm and 0.49±0.07cm after applying PEEP of 8, 12 and 15cm $H_{2}$O PEEP, respectively. It significantly decreased to 0.42±0.06cm, 0.41±0.06cm and 0.40±0.06cm after hyperventilation, $EtCO_{2}$ range 35–37, 32–34 and 29–31 mmHg. Results were statistically significant but clinically not significant. Conclusion: We conclude that there are acute and dynamic alterations in ONSD in response to hyperventilation and presence of PEEP in anaesthetised patients. Ocular sonography may be used as a reliable indicator of acute variations in ICP.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6644203/pdf
Ending Page	543
Page Count	7
Starting Page	537
File Format	XHTML
ISSN	00195049
e-ISSN	09762817
DOI	10.4103/ija.ija_861_18
Journal	Indian Journal of Anaesthesia
Issue Number	7
Volume Number	63
Language	English
Publisher	Medknow
Publisher Date	2019-01-01
Access Restriction	Open
Subject Keyword	Anesthesiology Carbon Dioxide Hyperventilation Intracranial Hypertension Optic Nerve Indian Journal of Anaesthesia, Volume 63, Issue 7
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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