Additional predictive value of optic nerve sheath diameter for neurological prognosis after cardiac arrest: a prospective cohort study

Marlous M.L.H. Verhulst*, Iris M. Visser, Hanneke M. Keijzer, Nicole L.M. de Kruijf, Erwin J.G. Peters, Thom Wilbers, Roel V. Peelen, Jeannette Hofmeijer, Michiel J. Blans

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Downloads (Pure)

Abstract

Background: The goal is to estimate the additional value of ultrasonographic optic nerve sheath diameter (ONSD) measurement on days 1–3, on top of electroencephalography (EEG), pupillary light reflexes (PLR), and somatosensory evoked potentials (SSEP), for neurological outcome prediction of comatose cardiac arrest patients. We performed a prospective longitudinal cohort study in adult comatose patients after cardiac arrest. ONSD was measured on days 1–3 using ultrasound. Continuous EEG, PLR, and SSEP were acquired as standard care. Poor outcome was defined as cerebral performance categories 3–5 at 3–6 months. Logistic regression models were created for outcome prediction based on the established predictors with and without ONSD. Additional predictive value was assessed by increase in sensitivity for poor (at 100% specificity) and good outcome (at 90% specificity). Results: We included 100 patients, 54 with poor outcome. Mean ONSD did not differ significantly between patients with good and poor outcome. Sensitivity for predicting poor outcome increased by adding ONSD to EEG and SSEP from 25% to 41% in all patients and from 27% to 50% after exclusion of patients with non-neurological death. Conclusions: ONSD on days 1–3 after cardiac arrest holds potential to add to neurological outcome prediction. Trial registration: clinicaltrials.gov, NCT04084054. Registered 10 September 2019, https://www.clinicaltrials.gov/study/NCT04084054 .

Original languageEnglish
Article number46
JournalThe Ultrasound Journal
Volume15
Issue number1
DOIs
Publication statusPublished - 8 Dec 2023

Keywords

  • Cardiac arrest
  • Intracranial pressure
  • Neurological outcome
  • Optic nerve sheath diameter
  • Prognosis
  • Ultrasound

Fingerprint

Dive into the research topics of 'Additional predictive value of optic nerve sheath diameter for neurological prognosis after cardiac arrest: a prospective cohort study'. Together they form a unique fingerprint.

Cite this