FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / J Vet Emerg Crit Care (San Antonio) / Evaluation of transpalpebral ultrasonographic measurement of...
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)2021; 31(3); 315-322; doi: 10.1111/vec.13061

Evaluation of transpalpebral ultrasonographic measurement of optic nerve sheath diameter for indirect assessment of intracranial pressure in anesthetized and standing healthy adult horses.

Abstract: To determine whether an association exists between direct intracranial pressure (ICP) measurement and ultrasonographic measurement of optic nerve sheath diameter (ONSD) in anesthetized and standing horses. Methods: Cross-sectional study performed on a convenience sample of healthy adult horses. Methods: University teaching hospital. Methods: Eight adult horses donated to the University. Enrolled horses were free of abnormalities on physical examination, CBC, neurological evaluation, and ophthalmological examination. Results: Horses were anesthetized in lateral recumbency for placement of an ICP transducer. Three head positions (neutral, elevated, and lowered) were used to alter ICP. ICP and ONSD in 2 directions (D1 and D2) were recorded at 5 and 10 minutes after position change to elevated and lowered. ICP and ONSD measurements were repeated in standing sedated horses 24-36 hours after recovery from anesthesia. Linear regressions were performed with ICP as the dependent variable and ONSD as the independent variable by head position and times. Linear regressions were also performed for change from neutral under anesthesia, with ONSD as the independent variable and ICP as the dependent variable, by head position and times. Significance was set at P < 0.05. There was a moderate association between ICP and ONSD in horses with head lowered at 5 and 10 minutes (R values = 63%-78%) and weak association in head elevated at 10 minutes (R values = 56%-63%). There was a weak association between change from neutral ICP and change from neutral ONSD in the elevated anesthetized position at 10 minutes for summed D1 + D2 (R  = 33%). Conclusions: Consistent associations between direct ICP and ONSD in anesthetized or standing horses were not observed. This inconsistency limits the clinically utility of transpalpebral ultrasonographic ONSD measurement for ICP monitoring in horses.
© Veterinary Emergency and Critical Care Society 2021.
Get Full Text
Publication Date: 2021-04-27 PubMed ID: 33905179DOI: 10.1111/vec.13061Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Evaluation Study
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research aimed to explore if there’s any correlation between direct intracranial pressure (ICP) measurement and ultrasonographic measurement of optic nerve sheath diameter (ONSD) in anesthetized and standing horses. However, it concluded that the inconsistency of this association hampers its clinical use in monitoring ICP in horses through non-invasive ultrasonographic ONSD measurement.

Study Methodology

  • The study was cross-sectional in nature and carried out on eight adult horses donated to a university teaching hospital. These horses were selected as they showed no abnormalities during physical examination, complete blood count (CBC), neurological evaluation, and ophthalmological inspection.
  • The experiment was conducted under anesthesia with the horses lying on their sides (lateral recumbency) for the placement of an ICP transducer. ICP and ONSD measurements were taken in three different head positions: neutral, elevated, and lowered. The horses’ ICP and ONSD were recorded 5 and 10 minutes after elevating and lowering their heads.
  • Further, these measurements were repeated 24-36 hours after the horses recovered from anesthesia, but this time when they were standing and sedated.

Data Analysis and Findings

  • Data was analyzed using linear regressions, keeping ICP as the dependent variable and ONSD as the independent variable. These regressions were evaluated for each head position and at different time intervals.
  • Statistical significance was set at P < 0.05. If P was less than this threshold, it means the relationship was acknowledged as significant.
  • Modest correlation between ICP and ONSD was seen in horses with the head lowered at 5 and 10 minutes, while a weak correlation was observed in those with elevated heads at the 10-minute mark.
  • No strong association was found between the variation from neutral ICP and variation from neutral ONSD in horses with their heads elevated at the 10-minute mark post anesthesia.
  • The study concluded that strong, consistent correlations between directly measured ICP and ultrasonographically measured ONSD in anesthetized or standing horses were not observed. The inconsistency noted substantially restricts the clinical utility of this non-invasive method for ICP monitoring in horses.

Conclusion

  • The research aimed to provide an alternative, less invasive method to monitor ICP in horses. It attempted to establish a correlation between the directly measured ICP and ultrasonographically determined ONSD. However, the results showed weak to modest associations, limiting its practical implementation due to the noted inconsistency.

Cite This Article

APA
Bramski JH, Reed RA, Diehl KA, Epstein KL, Ryan CA. (2021). Evaluation of transpalpebral ultrasonographic measurement of optic nerve sheath diameter for indirect assessment of intracranial pressure in anesthetized and standing healthy adult horses. J Vet Emerg Crit Care (San Antonio), 31(3), 315-322. https://doi.org/10.1111/vec.13061

Publication

Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
NlmUniqueID: 101152804
Country: United States
Language: English
Volume: 31
Issue: 3
Pages: 315-322

Researcher Affiliations

Bramski, Jessica H
  • Department of Large Animal Medicine, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA.
Reed, Rachel A
  • Department of Large Animal Medicine, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA.
Diehl, Kathryn A
  • Department of Small Animal Medicine, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA.
Epstein, Kira L
  • Department of Large Animal Medicine, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA.
Ryan, Clare A
  • Department of Large Animal Medicine, College of Veterinary Medicine, The University of Georgia, Athens, Georgia, USA.

MeSH Terms

  • Animals
  • Cross-Sectional Studies
  • Female
  • Horse Diseases / diagnostic imaging
  • Horses
  • Intracranial Hypertension / diagnostic imaging
  • Intracranial Hypertension / veterinary
  • Intracranial Pressure / physiology
  • Male
  • Monitoring, Physiologic / methods
  • Monitoring, Physiologic / veterinary
  • Optic Nerve / diagnostic imaging
  • Prospective Studies
  • Ultrasonography / methods
  • Ultrasonography / veterinary

Grant Funding

  • University of Georgia Love of the Horse Research Endowment

References

This article includes 33 references
  1. Armstead WM. Cerebral blood flow autoregulation and dysautoregulation. Anesthesiol Clin 2016;34(3):465-477.
  2. Rangel-Castilla L, Rangel-Castillo L, Gopinath S, Robertson CS. Management of intracranial hypertension. Neurol Clin 2008;26(2):521-541.
  3. Wilson MH. Monro-Kellie 2.0: the dynamic vascular and venous pathophysiological components of intracranial pressure. J Cereb Blood Flow Metab 2016;36(8):1338-1350.
  4. Hardefeldt LY. Hyponatraemic encephalopathy in azotaemic neonatal foals: four cases. Aust Vet J 2014;92(12):488-491.
  5. Scott TR, Kronsten VT, Hughes RD, Shawcross DL. Pathophysiology of cerebral oedema in acute liver failure. World J Gastroenterol 2013;19(48):9240-9255.
  6. Wilcox AL, Calise DV, Chapman SE. Hypoxic/ischemic encephalopathy associated with placental insufficiency in a cloned foal. Vet Pathol 2009;46(1):75-79.
  7. Dunn LT. Raised intracranial pressure. J Neurol Neurosurg Psychiatry 2002;73(Suppl 1):i23-i27.
  8. Le Roux P, Menon DK, Citerio G. The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: evidentiary tables: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine. Neurocrit Care 2014;21(Suppl 2):S297-S361.
  9. Farahvar A, Gerber LM, Chiu YL. Increased mortality in patients with severe traumatic brain injury treated without intracranial pressure monitoring. J Neurosur 2012;117(4):729-734.
  10. Shen L, Wang Z, Su Z. Effects of intracranial pressure monitoring on mortality in patients with severe traumatic brain injury: a meta-analysis. PLoS One 2016;11(12):e0168901.
  11. You W, Feng J, Tang Q. Intraventricular intracranial pressure monitoring improves the outcome of older adults with severe traumatic brain injury: an observational, prospective study. BMC Anesthesiol 2016;16(1):35.
  12. Han J, Yang S, Zhang C. Impact of intracranial pressure monitoring on prognosis of patients with severe traumatic brain injury: a PRISMA systematic review and meta-analysis. Medicine 2016;95(7):e2827.
  13. Raboel PH, Bartek J, Andresen M. Intracranial pressure monitoring: invasive versus non-invasive methods-a review. Crit Care Res Pract 2012;2012:950393.
  14. Smith JJ, Fletcher DJ, Cooley SD, Thompson MS. Transpalpebral ultrasonographic measurement of the optic nerve sheath diameter in healthy dogs. J Vet Emerg Crit Care 2018;28(1):31-38.
  15. Zhang X, Medow JE, Iskandar BJ. Invasive and noninvasive means of measuring intracranial pressure: a review. Physiol Meas 2017;38(8):R143-R82.
  16. Brosnan RJ, LeCouteur RA, Steffey EP. Direct measurement of intracranial pressure in adult horses. Am J Vet Res 2002;63(9):1252-1256.
  17. Maissan IM, Dirven PJ, Haitsma IK. Ultrasonographic measured optic nerve sheath diameter as an accurate and quick monitor for changes in intracranial pressure. J Neurosurg 2015;123(3):743-747.
  18. Raffiz M, Abdullah JM. Optic nerve sheath diameter measurement: a means of detecting raised ICP in adult traumatic and non-traumatic neurosurgical patients. Am J Emerg Med 2017;35(1):150-153.
  19. Robba C, Donnelly J, Cardim D. Optic nerve sheath diameter ultrasonography at admission as a predictor of intracranial hypertension in traumatic brain injured patients: a prospective observational study. J Neurosurg 2019;132(4):1279-1285.
  20. Sekhon MS, Griesdale DE, Robba C. Optic nerve sheath diameter on computed tomography is correlated with simultaneously measured intracranial pressure in patients with severe traumatic brain injury. Intensive Care Med 2014;40(9):1267-1274.
  21. Cooley SD, Scrivani PV, Thompson MS. Correlations among ultrasonographic measurements of optic nerve sheath diameter, age, and body weight in clinically normal horses. Vet Radiol Ultrasound 2016;57(1):49-57.
  22. Killer HE, Laeng HR, Flammer J, Groscurth P. Architecture of arachnoid trabeculae, pillars, and septa in the subarachnoid space of the human optic nerve: anatomy and clinical considerations. Br J Ophthalmol 2003;87(6):777-781.
  23. Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg 1997;87(1):34-40.
  24. Dubourg J, Javouhey E, Geeraerts T. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2011;37(7):1059-1068.
  25. Ilie LA, Thomovsky EJ, Johnson PA. Relationship between intracranial pressure as measured by an epidural intracranial pressure monitoring system and optic nerve sheath diameter in healthy dogs. Am J Vet Res 2015;76(8):724-731.
  26. Scrivani PV, Fletcher DJ, Cooley SD. T2-weighted magnetic resonance imaging measurements of optic nerve sheath diameter in dogs with and without presumed intracranial hypertension. Vet Radiol Ultrasound 2013;54(3):263-270.
  27. Ballantyne SA, O'Neill G, Hamilton R, Hollman AS. Observer variation in the sonographic measurement of optic nerve sheath diameter in normal adults. Eur J Ultrasound 2002;15(3):145-149.
  28. Lochner P, Coppo L, Cantello R. Intra- and interobserver reliability of transorbital sonographic assessment of the optic nerve sheath diameter and optic nerve diameter in healthy adults. J Ultrasound 2016;19(1):41-45.
  29. Liu D, Li Z, Zhang X. Assessment of intracranial pressure with ultrasonographic retrobulbar optic nerve sheath diameter measurement. BMC Neurol 2017;17(1):188.
  30. Moore RM, Trims CM. Effect of xylazine on cerebrospinal fluid pressure in conscious horses. Am J Vet Res 1992;53(9):1558-1561.
  31. Olson DM, Ortega Peréz S, Ramsay J. Differentiate the source and site of intracranial pressure measurements using more precise nomenclature. Neurocrit Care 2019;30(2):239-243.
  32. Alarcon JD, Rubiano AM, Okonkwo DO. Elevation of the head during intensive care management in people with severe traumatic brain injury. Cochrane Database Syst Rev 2017;12(12):CD009986.
  33. Sanri E, Karacabey S. The impact of head of bed elevation on optic nerve sheath diameter in cervical collar applied healthy volunteers. J Emerg Med 2019;56(4):371-377.

Citations

This article has been cited 2 times.
  1. Mitchell KG, Appleby RB, Sinclair MD, Singh A. The effect of laparoscopy on intracranial pressure as measured by optic nerve sheath diameter: A review.. Can Vet J 2022 Apr;63(4):416-421.
    pubmed: 35368391
  2. Vitiello L, De Bernardo M, Capasso L, Cornetta P, Rosa N. Optic Nerve Ultrasound Evaluation in Animals and Normal Subjects.. Front Med (Lausanne) 2021;8:797018.
    doi: 10.3389/fmed.2021.797018pubmed: 35071277google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.