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KMID : 1148420190020010017
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Journal of Neurointensive Care
2019 Volume.2 No. 1 p.17 ~ p.24
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Prognostic Value of Optic Nerve Sheath Diameter in Patients after Extracorporeal Cardiopulmonary Resuscitation
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Kim Young-Jin
Ryu Jeong-Am
Kim Yong-Oh
Cho Yang-Hyun
Yang Jeong-Hoon
Lee Sang-Kil
Baek Ji-Sun
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Abstract
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Objective: To determine whether optic nerve sheath diameter (ONSD) could be used to predict neurological outcomes in patients after extracorporeal cardiopulmonary resuscitation (ECPR).
Methods: This was a retrospective and observational study of adult unconscious patients who were evaluated by brain computed tomography (CT) scan within 48 hours after ECPR between May 2010 and December 2016. ONSDs were estimated on initial brain CT. The primary outcome was neurological status upon hospital discharge assessed with Cerebral Performance Categories (CPC) scale. CPC scores of 1 and 2 indicated good neurological outcome while CPC scores of 3, 4, and 5 indicated poor neurological outcome.
Results: Among 52 unconscious patients, survival to discharge was identified in 19 (36.5%) patients. Of these 19 survivors, 13 (25.0%) had good neurological outcome (CPC score of 1 or 2). ONSDs and their modification in the poor neurological outcome group were significantly greater than those in the good neurological outcome group (all p≤0.003). However, eyeball transverse diameter was not significantly different between the two groups (p=0.770). Analysis of the receiver operating characteristic curves for predicting poor neurological outcome showed that ONSDs had considerable predictive value (C-statistics: 0.735 to 0.812). In addition, ONSDs and their modification had similar performances for predicting poor neurological outcome.
Conclusion: ONSDs measured with CT may be used to predict neurological outcomes of ECPR survivors.
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KEYWORD
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Brain computed tomography, Optic nerve sheath diameter, Cardiopulmonary resuscitation, Extracorporeal membrane oxygenation
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