Research Letter: Bedside Ultrasound Measurement of Optic Nerve Sheath Diameter in Patients with Sepsis: A Prospective Observational Study

INTRODUCTION

Sepsis-associated encephalopathy (SAE) is a serious condition that can lead to cognitive impairment, sleep disturbances, delirium and even coma. One of the complications of SAE is brain edema leading to high intracranial pressure (ICP), which, in extreme cases can even lead to death. Therefore, bedside ultrasonography measurement of the optic nerve sheath diameter (ONSD) could be used as a non-invasive technique to estimation of high intracranial pressure.
The goal of this study was to compare the differences in ONSD/ICP between patients with and without SAE.

METHODS

This study was conducted in the general intensive care unit and included patients diagnosed with sepsis. The patients were divided into three groups: non-SAE group, SAE group, and SAE recovery group. ONSD, was measured within 24 h of admission at the retrobulbar 3 mm position.

RESULTS

90 patients with sepsis underwent 142 ONSD measurements; non-SAE 71 (median ONDS 5.1 mm), SAE 51 (median ONDS 5.9) and SAE recovery 20 (median ONDS 5.35 (mm).

CONCLUSIONS

The author concluded that ONSD may be a new diagnostic tool for SAE. They also noted that there is not enough evidence to show that patients with wider ONSD values have a higher risk of death, and that ONSD cannot be used as an indicator for predicting the prognosis of patients with SAE.