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Changes in Optic Nerve Sheath Diameter in Response to Various Levels of End Tidal Carbon Dioxide Levels

NCT02711774 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 30

Last updated 2016-11-17

No results posted yet for this study

Summary

Intracranial Pressure ( ICP ) monitoring is an essential component of traumatic brain injured ( TBI ) patients management. The clinical signs of raised ICP may be unreliable and may reflect relatively late cerebral decompensation. ICP may be monitored by invasive or non invasive techniques. While invasive techniques show the real time values of ICP, they are associated with many complications like, intracranial bleeding and infection, occlusion of the catheter tip by blood, debris and difficult to locate ventricle in presence of cerebral oedema. All these drawbacks of invasive methods can be averted by employing non invasive techniques of ICP monitoring. Although they do not show a real time value but are excellent tools to detect presence or absence of raised ICP. Elevated ICP can be detected by Computarised tomographic scan (CT) or Magnetic resonance imaging (MRI) but , these techniques are time consuming and require transportation of a patients who may be unstable .The quick and non invasive nature of ultrasonography is fast becoming popular for rapid detection of elevated ICP at bedside in emergency and ICU by monitoring the optic nerve sheath diameter ( ONSD ). Its limitations notwithstanding, ultrasonographic ONSD monitoring is likely to be more reliable than clinical assessment in the diagnosis of intracranial hypertension especially, when patient is under sedation which precludes proper clinical examination. Therefore, in recent years ,among non invasive methods, bedside ocular ultrasonography to monitor ICP has gained popularity.

Carbon dioxide being a potent modulator of cerebral vascular tone, alters the ICP by changing the size of cerebral vasculature and thereby, cerebral blood flow (CBF) and this action occurs very rapidly, over e period of few minutes. In a range of PaCO2 20mmHg to 80 mmHg the cerebral blood flow changes in a linear manner. End tidal carbon dioxide concentration(EtCO2) is a surrogate measure of PaCO2 (especially in a haemodyanimically stable patient with healthy lungs ) and is routinely monitored continuously in patients subjected to general anaesthesia. To date there is very little literature on the effects changing EtCO2 on ONSD . This prompted us to conduct this study to find out the effects of different levels of EtCO2 on ONSD.

Conditions

  • Brachial Plexus Injury

Interventions

DEVICE

ultrasonography

ONSD will be measured by a 6-13 MHz linear probe of the ultrasound machine.

Sponsors & Collaborators

  • All India Institute of Medical Sciences

    lead OTHER

Principal Investigators

  • Indu Kapoor · AIIMS, New Delhi

Eligibility

Min Age
18 Years
Max Age
65 Years
Sex
ALL
Healthy Volunteers
Yes

Timeline & Regulatory

Start
2016-08-31
Primary Completion
2016-11-30
Completion
2016-11-30

Countries

  • India

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT02711774 on ClinicalTrials.gov