Çukurova University Faculty of Medicine
Pediatric Intensive Care Unit

Author Of 2 Presentations

DETERMINATION OF NORMAL VALUES OF OPTIC NERVE SHEATH DIAMETER IN NEWBORNS  WITH POINT-OF-CARE ULTRASOUND

Room
Doppler Hall
Date
19.06.2019
Session Time
11:10 - 12:10
Duration
10 Minutes

Abstract

Background

Early diagnosis of acute intracranial hypertension is essential for the optimal treatment. Opthalmic ultrasound measurement of optic nerve sheath diameter (ONSD) is an easy, portabl, noninvasive and a radiation free technique to determine increased intracranial pressure.

Objectives

The aim was to establish the normal values for ONSD in premature and mature newborns.

Methods

Newborns without intracranial pathology in NICUs and Obstetrics/ Gynecology Departments were included. ONSD were measured at a distance 2, 2.5 and 3 mm beyond the right optic nerve head in preterms and at 3 mm in term infants. Measurements were done by a pediatric intensive care fellow who expertise with point-of-care ultrasound.

Results

554 newborn infants (premature:253, mature:301) were included in the study. The mean ONSD of premature babies from 2, 2.5 and 3 mm were 0.32±0.03 cm (range 0.20-0.42 cm), 0.33±0.03 cm (range 0.22-0.45 cm) and 0.36±0.02 cm (range 0.29-0.45 cm), respectively. The mean ONSD from 3 mm behind the optic disc of mature babies was 0.40±0.027 cm (range 0.33-0.36 cm). There was no significant difference in ONSD between males and females. In the correlation analysis, a significant, strong and positive correlation was found between ONSD measurements from 2, 2.5 and 3 mm behind the optic disc and gestational age, actual weight, birth height and birth head circumference.

Conclusion

Our study is important in terms of being the largest series in the literatu defining the normal range of ONSD in newborns. The normal values reported by present study may be used for evaluating the ONSD of newborns with and without increased incracranial pressure.

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THE COMPARISON OF THE CARDIAC INDEX VALUES MEASURED BY CRITICAL CARE ECHOCARDIOGRAPHY WITH THE VALUES MEASURED BY PICCO IN THE PEDIATRIC INTENSIVE CARE UNIT

Abstract

Background

Pulse index Contour Cardiac Output (PiCCO) monitoring is an invasive, hemodynamics monitor and provides continuous cardiac output (CO) and cardiac index (CI), preload, systemic vascular resistance index measurements. Use of critical care echocardiography by the pediatric intensivists has been increased. Cardiac output and CI can be measured with echocardiography.

Objectives

In this study we aimed to compare the CO and CI values which were measured by pediatric intensivists with critical-care echocardiography and measured by PiCCO monitor in critically ill pediatric patients.

Methods

A total of 49 echocardiographic measurements were performed and recorded from 15 patients with diagnosis of septic shock, cardiogenic shock, acute respiratory distress syndrome, pulmonary edema. Echocardiographic measurements were performed by two pediatric intensive care fellows. The distance of left ventricle outflow tract (LVOT) in parasternal longer axis and LVOT-Velocity Time Integral (LVOT-VTI) measurement was performed in the apical five chamber image. Cardiac output_echocardiography (CO_echo) and CI_echocardiography (CI_echo) was calculated with these measurements. PiCCO monitoring was performed.

Results

Cardiac output (CO_picco) and CI (CI_picco) measured by PiCCO simultaneously with echocardiographic measurements were recorded another researcher who blind to echocardiographic measurements. We detected strong positive correlation between CO_echo and CO_picco measurements (p<0.001, r=0.985) and a strong positive correlation between CI_echo and CI_picco measurements (p<0.001, r=0.943).

Conclusion

According to our study results we suggested that echocardiographic CO measurements which will be performed by an experienced pediatric intensive care team with critical care echocardiography may be as valuable as PiCCO measurements in the management of the fluid and vasoactive-inotropic treatment of critically ill pediatric patients.

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