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Citation
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Narayan V, Mohammed N, Savardekar AR, Patra DP, Notarianni C, Nanda A. World Neurosurg. 2018; 114: 293-300. |
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Affiliation
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Department of Neurosurgery, LSU-HSC, Shreveport, Louisiana, USA. Electronic address: ananda@lsuhsc.edu. |
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Abstract
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BACKGROUND: Traumatic brain injury [TBI] is a leading cause of pediatric morbidity and mortality worldwide and intracranial pressure [ICP] monitoring plays a crucial role in its management. Based on existing literature, the authors review the current practicing non-invasive ICP monitoring devices and their accuracy in predicting raised ICP in pediatric TBI.
MATERIALS AND METHODS: A thorough literature search was conducted on PubMed, Medline and Cochrane data base, articles were selected systematically, reviewed completely and relevant data was summarized and discussed.
RESULTS: and Observations: A total of 27 publications pertaining to pediatric TBI were included and reviewed. We found various modalities of non-invasive ICP monitoring devices used over the last few years. The non-invasive modalities so far attempted in pediatric TBI and so reviewed here are transcranial doppler, optic nerve sheath diameter, oto-acoustic emission, near infra-red spectroscopy, contrast-enhanced USG and quantitative pupillometry.
CONCLUSION: Invasive monitoring methods are the current 'gold standard' for monitoring ICP; however, complications due to their invasive nature are of concern. Of all the non-invasive methods based on current literature, we found transcranial doppler and optic nerve sheath diameter assessment as the best tools to monitor ICP in pediatric TBI. The promising results and developments of non-invasive ICP monitoring modalities with its ideal features of high sensitivity, diagnostic accuracy and simple acquisition technique may make it the future of neurointensive monitoring in pediatric TBI.
Copyright © 2018. Published by Elsevier Inc.
Language: en |