OPTIC-ICP
Research type
Research Study
Full title
Optic nerve sheath ultrasound to track changes in Intra Cranial Pressure
IRAS ID
246277
Contact name
Sam Hutchings
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Severe Traumatic Brain Injury (TBI) is significant problem. Management of patients with TBI in tertiary neuroscience centres frequently involves the use of intra parenchymal monitoring of intracranial pressure (ICP). However, not all patients are initially managed in such facilities and it can be many days before such management can be initiated.
Optic nerve sheath diameter ultrasound (ONSD US) is a non-invasive method of quantifying ICP which has been found to have an acceptable correlation during the acute phase of TBI. The optic nerve is continuous with the coverings of the brain and any increase in brain swelling is transmitted via cerebral spinal fluid to the optic nerve sheath, causing dilatation of that structure. Studies have shown this phenomenon to occur within minutes of acute changes in ICP. However, an important caveat is that ONSD estimation of ICP relies on normal intracranial flow dynamics to allow for adequate displacement of the sheath. Following a severe TBI, the dynamics of CSF flow can alter over time and there is no data relating to the continuing use of ONSD US to track changes in ICP over a more prolonged time course. Many of the reported studies have taken one-off measurements of ONSD / ICP, usually early in the clinical course. To our knowledge, no study has sequentially tracked ICP in individual patients over time, as opposed to stratifying groups of patients based on the presence of high ICP at a single time point and examining the mean ONSD value.
REC name
London - Harrow Research Ethics Committee
REC reference
18/LO/1868
Date of REC Opinion
21 Feb 2019
REC opinion
Further Information Favourable Opinion