Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2016

Open Access 01-12-2016 | Commentary

Portable infrared pupillometry in critical care

Authors: Merlin D. Larson, Vineeta Singh

Published in: Critical Care | Issue 1/2016

Login to get access

Abstract

Infrared pupillometry was introduced in 1962 but portable instruments that use this technology have only recently become available in the hospital setting. Questions surrounding the accuracy of these instruments have been addressed by documenting the inter-observer agreement on pupillary measurements and also by comparisons with standard pen-light examinations. The following commentary summarizes the development of these devices and provides a wider perspective on how the pupil and its reflexes might be used in providing care for patients with critical illness.
Literature
1.
Couret D, Boumaza D, Grisotto C, Triglia T, Pellegrini L, Ocquidant P, et al. Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study. Crit Care. 2016;20(1):99.CrossRefPubMedPubMedCentral
2.
Taylor WR, Chen JW, Meltzer H, Gennarelli TA, Kelbch C, Knowlton S, et al. Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury. Technical note. J Neurosurg. 2003;98(1):205–13.CrossRefPubMed
3.
Du R, Meeker M, Bacchetti P, Larson MD, Holland MC, Manley GT. Evaluation of the portable infrared pupillometer. Neurosurgery. 2005;57(1):198–203. discussion 198–203.CrossRefPubMed
4.
Larson MD. Alteration of the human pupillary light reflex by general anesthesia. Anesthesiol Rev. 1989;16:25–9.
5.
Shirozu K, Setoguchi H, Tokuda K, Karashima Y, Ikeda M, Kubo M, et al. The effects of anesthetic agents on pupillary function during general anesthesia using the automated infrared quantitative pupillometer. J Clin Monit Comput. 2016. Published ahead of print. doi:10.​1007/​s10877-016-9839-3.
6.
Larson MD, Muhiudeen I. Pupillometric analysis of the "absent light reflex". Arch Neurol. 1995;52:369–72.CrossRefPubMed
7.
Chen JW, Gombart ZJ, Rogers S, Gardiner SK, Cecil S, Bullock RM. Pupillary reactivity as an early indicator of increased intracranial pressure: The introduction of the Neurological Pupil Index. Surg Neurol Int. 2011;2:82.CrossRefPubMedPubMedCentral
8.
Kramer CL, Rabinstein AA, Wijdicks EF, Hocker SE. Neurologist versus machine: is the pupillometer better than the naked eye in detecting pupillary reactivity. Neurocrit Care. 2015;21(2):309–11.CrossRef
9.
Loewenfeld IE. The pupil: anatomy, physiology and clinical applications. Detroit: Wayne State University Press; 1999.
10.
Larson MD, Behrends M. Portable infrared pupillometry: a review. Anesth Analg. 2015;120(6):1242–53.CrossRefPubMed
11.
Paulus J, Roquilly A, Beloeil H, Theraud J, Asehnoune K, Lejus C. Pupillary reflex measurement predicts insufficient analgesia before endotracheal suctioning in critically ill patients. Crit Care. 2013;17(4):R161.CrossRefPubMedPubMedCentral
12.
13.
Lukaszewicz AC, Dereu D, Gayat E, Payen D. The relevance of pupillometry for evaluation of analgesia before noxious procedures in the intensive care unit. Anesth Analg. 2015;120(6):1297–300.CrossRefPubMed
14.
Bokoch MP, Behrends M, Neice A, Larson MD. Fentanyl, an agonist at the mu opioid receptor, depresses pupillary unrest. Auton Neurosci. 2015;189:68–74.CrossRefPubMed
15.
Pedersen T, Nicholson A, Hovhannisyan K, Moller AM, Smith AF, Lewis SR. Pulse oximetry for perioperative monitoring. Cochrane Database Syst Rev. 2014;3:CD002013.PubMed
Metadata
Title
Portable infrared pupillometry in critical care
Authors
Merlin D. Larson
Vineeta Singh
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2016
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-016-1349-7

Other articles of this Issue 1/2016

Critical Care 1/2016 Go to the issue

Letter

Work of breathing, not dysoxia, as the cause of low central venous blood O2 saturation in sepsis

Commentary

A commentary on the 2015 Canadian Clinical Practice Guidelines in glutamine supplementation to parenteral nutrition

Erratum

Erratum to: ‘Measuring energy expenditure in the intensive care unit: a comparison of indirect calorimetry by E-sCOVX and Quark RMR with Deltatrac II in mechanically ventilated critically ill patients’

Research

High-dose intravenous selenium does not improve clinical outcomes in the critically ill: a systematic review and meta-analysis

Research

Does galactomannan testing increase diagnostic accuracy for IPA in the ICU? A prospective observational study

Research

Daily urinary urea excretion to guide intermittent hemodialysis weaning in critically ill patients