masterThesis
Determinación del promedio del diámetro de la vaina del nervio óptico en voluntarios sanos de un hospital de Bogotá
Autor
Rodriguez Aparicio, Edith Elianna
Institución
Resumen
Introduction: Intracranial pressure monitoring plays a fundamental role in the comprehensive management of neurocritical patients. However, it is not always possible to carry out continuous monitoring with direct methods by invasive techniques such as ventricular shunt catheter measurements, so non-invasive techniques are absolutely relevant for the assessment of this group of patients. Ultrasonography at the bedside with transcranial Doppler and evaluation of the optic nerve sheath diameter are two well-studied measures that allow an initial approximation, it is necessary to establish normality in these measurements so clinicians could make decisions in the context of the neurocritical patient Objective: To determine the average optic nerve sheath diameter (ONSD), in a healthy adult population of the city of Bogotá using the CLOSED protocol and adjustment for the transverse diameter of the eyeball (ONSD/TED). Methodology: The ONSD was measured with the application of the CLOSED protocol and ONSD/TED o in 246 subjects who met the inclusion criteria, head circumference and anthropometric measurements were determined, finally an inferential analysis of the possible coincidence of baseline conditions with the ONSD measurement and also the behavior between both eyes Results: 230 participants were analyzed, the average of the ONSD was found 0.449 cm (IQR 0.147) for the right eye and 0.454 (IQR 0.152) for the left eye with extreme data (0.28 cm - 0.7cm), 75 % of patients showed a value similar to that reported in other populations; the average of the ONSD/TED index were 0.22 (IQR 0.07) for the right eye and 0.22 (IQR 0.06) for the left one with extreme values between 0.1 and 0.5. These measurements did not showed correlation with the baseline characteristics of the participants, but ONSD and ONSD/TED showed good correlation in both eyes (rho 0,96, p<0,005 and rho 0.87, p<0,005) Conclusions: The results of the analysis show that the average of the ONSD and ONSD/TED measurement is similar to other populations, however, the heterogeneous distribution and the presence of extreme values suggest that there are other factors rather than multiculturalism that may affect the measure such as the height of the city. The use of the isolated measurement may not be sufficient, but the asymmetry in the measurements could indicate an abnormal behavior of the ICP, future studies are necessary to determine the association of the population average with the presence of ICH.