Traumatic Brain Injury
Conditions
Brief summary
Raised intracranial pressure (ICP) is a common and life threatening condition especially in patients with traumatic brain injury.There are many methods for monitoring the increased (ICP) either invasive or non- invasive ,but the gold standard is invasive method. Optic nerve sheath ultrasonography provides a very promising bedside tool for detection of increased ICP. This study will monitor the dynamic changes of intracranial pressure by optic nerve sheath diameter (ONSD) in response to mannitol osmotherapy
Detailed description
Traumatic brain injury is the main cause of increased intracranial pressure (ICP) in the intensive care . There are multiple methods for monitoring the raised ICP either invasive or non-invasive.The gold standard is the invasive devices because it is more accurate and reliable .However ,it requires a surgical intervention which has many hazards such as (infection ,hemorrhage,malfunction ). Optic nerve sheath ultrasonography is a promising bedside tool for detection of increased ICP. The optic nerve is surrounded by cerebro-spinal fluid ,thus if the circulation of cerebro-spinal fluid not blocked ,an increase in ICP will be transmitted through the subarachnoid space around the optic nerve within the nerve sheath especially the retro-bulbar segment. The study will be conducted to monitor the dynamic changes of intracranial pressure by optic nerve sheath diameter (ONSD) in response to mannitol osmotherapy as a primary outcome and secondary to evaluate the efficacy of ONSD in assessing the severity of the disease
Interventions
DIAGNOSTIC_TESTOptic nerve sheath diameter
The intracranial pressure will be measured by the optic nerve sheath diameter and after giving the mannitol osmotherapy the intracranial pressure will be monitored by the optic nerve sheath diameter
Sponsors
Mansoura University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Masking description
No masking
Intervention model description
prospective observational study
Eligibility
Sex/Gender
ALL
Age
21 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients with traumatic brain injury
Exclusion criteria
* Patients with history of optic neuritis * past history of eye trauma * patient with optic nerve trauma * patient with history of arachnoid cyst of the optic nerve * high myopic patients * patients with cavernous sius mass
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessing the changes in the intracranial pressure | from 20 minutes before mannitol therapy (basal reading) till 48 hours after the end of mannitol infusion | It will be monitored and recorded the changes in intracranial pressure to the mannitol therapy .Basal (before mannitol therapy).20 minutes after the end of mannitol infusion ,2 hours ,6 hours,12 hours ,24 hours and 48 hours after the end of mannitol infusion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessing the changes in the heart rate | from 20 minutes before mannitol therapy (basal reading ) till 48 hours after the end of mannitol infusion | It will be recorded basal (before mannitol therapy).20 minutes after the end of mannitol infusion ,2 hours ,6 hours,12 hours ,24 hours and 48 hours after the end of mannitol infusion |
| Assessing the changes in the mean arterial pressure | from 20 minutes before mannitol therapy(basal reading) till 48 hours after the end of mannitol infusion | It will be calculated according to the formula systolic blood pressure+2(diastolic blood pressure)recorded basal (before mannitol therapy).20 minutes after the end of mannitol infusion ,2 hours ,6 hours,12 hours ,24 hours and 48 hours after the end of mannitol infusion |
Countries
Egypt
Outcome results
None listed