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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2011

01-07-2011 | Review

Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis

Authors: Julie Dubourg, Etienne Javouhey, Thomas Geeraerts, Mahmoud Messerer, Behrouz Kassai

Published in: Intensive Care Medicine | Issue 7/2011

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Abstract

Purpose

To evaluate the diagnostic accuracy of ultrasonography of optic nerve sheath diameter (ONSD) for assessment of intracranial hypertension.

Methods

Systematic review without language restriction based on electronic databases, with manual review of literature and conference proceedings until July 2010. Studies were eligible if they compared ultrasonography of ONSD with intracranial pressure (ICP) monitoring. Data were extracted independently by three authors. Random-effects meta-analysis and meta-regression were performed.

Results

Six studies including 231 patients were reviewed. No significant heterogeneity was detected for sensitivity, specificity, positive and negative likelihood ratios or diagnostic odds ratio. For detection of raised intracranial pressure, pooled sensitivity was 0.90 [95% confidence interval (CI) 0.80–0.95; p for heterogeneity, p het = 0.09], pooled specificity was 0.85 (95% CI 0.73–0.93, p het = 0.13), and the pooled diagnostic odds ratio was 51 (95% CI 22–121). The area under the summary receiver-operating characteristic (SROC) curve was 0.94 (95% CI 0.91–0.96).

Conclusions

Ultrasonography of ONSD shows a good level of diagnostic accuracy for detecting intracranial hypertension. In clinical decision-making, this technique may help physicians decide to transfer patients to specialized centers or to place an invasive device when specific recommendations for this placement do not exist.
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Metadata
Title
Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis
Authors
Julie Dubourg
Etienne Javouhey
Thomas Geeraerts
Mahmoud Messerer
Behrouz Kassai
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-011-2224-2

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