Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study
Abstract Background Transcranial sonography is a point-of-care tool recommended in intensive care units (ICU) to monitor brain injured patients. Objectives of the study was to assess feasibility and reliability of the third ventricle (V3) diameter measurement using transcranial sonography (TCS) comp...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-05-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13613-021-00857-x |
| _version_ | 1831735105106739200 |
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| author | Rémy Widehem Paul Bory Frédéric Greco Frédérique Pavillard Kévin Chalard Alexandre Mas Flora Djanikian Julie Carr Nicolas Molinari Samir Jaber Pierre-François Perrigault Gerald Chanques |
| author_facet | Rémy Widehem Paul Bory Frédéric Greco Frédérique Pavillard Kévin Chalard Alexandre Mas Flora Djanikian Julie Carr Nicolas Molinari Samir Jaber Pierre-François Perrigault Gerald Chanques |
| author_sort | Rémy Widehem |
| collection | DOAJ |
| description | Abstract Background Transcranial sonography is a point-of-care tool recommended in intensive care units (ICU) to monitor brain injured patients. Objectives of the study was to assess feasibility and reliability of the third ventricle (V3) diameter measurement using transcranial sonography (TCS) compared to brain computed-tomography (CT), the gold standard measurement, and to measure the TCS learning curve. Design: prospective study, in a 16-bed neurological ICU in an academic hospital. Every consecutive brain injured adult patient, who required a brain CT and TCS monitoring were included. The V3 diameter was blindly measured by TCS and CT. Intraclass correlation coefficient (ICC) and Bland–Altman plot were used to assess the reliability and agreement between TCS and CT V3 measurements. Diagnosis performance of the V3 diameter using TCS to detect hydrocephalus was measured. Absolute difference between V3 measurement by residents and experts was measured consecutively to assess the learning curve. Results Among the 100 patients included in the study, V3 diameter could be assessed in 87 patients (87%) from at least one side of the skull. Both temporal windows were available in 70 patients (70%). The ICC between V3 diameter measured by TCS and CT was 0.90 [95% CI 0.84–0.93] on the right side, and 0.92 [0.88–0.95] on the left side. In Bland–Altman analysis, mean difference, standard deviation, 95% limits of agreement were 0.36, 1.52, − 2.7 to 3.3 mm, respectively, on the right side; 0.25, 1.47, − 2.7 to 3.1 mm, respectively, on the left side. Among the 35 patients with hydrocephalus, V3 diameters could be measured by TCS in 31 patients (89%) from at least one side. Hydrocephalus was, respectively, excluded, confirmed, or inconclusive using TCS in 35 (40%), 25 (29%) and 27 (31%) of the 87 assessable patients. After 5 measurements, every resident reached a satisfactory measurement compared to the expert operator. Conclusion TCS allows rapid, simple and reliable V3 diameter measurement compared with the gold standard in neuro-ICU patients. Aside from sparing irradiating procedures and transfers to the radiology department, it may especially increase close patient monitoring to detect clinically occult hydrocephalus earlier. Further studies are needed to measure the potential clinical benefit of this method. Trial registration: ClinicalTrials.gov ID: NCT02830269. |
| first_indexed | 2024-12-21T12:20:17Z |
| format | Article |
| id | doaj.art-57455fa3925548e181dacc8184cb323b |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-21T12:20:17Z |
| publishDate | 2021-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-57455fa3925548e181dacc8184cb323b2022-12-21T19:04:19ZengSpringerOpenAnnals of Intensive Care2110-58202021-05-0111111110.1186/s13613-021-00857-xTranscranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot studyRémy Widehem0Paul Bory1Frédéric Greco2Frédérique Pavillard3Kévin Chalard4Alexandre Mas5Flora Djanikian6Julie Carr7Nicolas Molinari8Samir Jaber9Pierre-François Perrigault10Gerald Chanques11Department of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Saint Eloi HospitalDepartment of Statistics, Montpellier University Hospital Center, La Colombière Hospital, and Institut Montpelliérain Alexander Grothendieck (IMAG), University of Montpellier, CNRSDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Saint Eloi HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalDepartment of Anaesthesia & Critical Care Medicine, Montpellier University Hospital Center, Gui de Chauliac HospitalAbstract Background Transcranial sonography is a point-of-care tool recommended in intensive care units (ICU) to monitor brain injured patients. Objectives of the study was to assess feasibility and reliability of the third ventricle (V3) diameter measurement using transcranial sonography (TCS) compared to brain computed-tomography (CT), the gold standard measurement, and to measure the TCS learning curve. Design: prospective study, in a 16-bed neurological ICU in an academic hospital. Every consecutive brain injured adult patient, who required a brain CT and TCS monitoring were included. The V3 diameter was blindly measured by TCS and CT. Intraclass correlation coefficient (ICC) and Bland–Altman plot were used to assess the reliability and agreement between TCS and CT V3 measurements. Diagnosis performance of the V3 diameter using TCS to detect hydrocephalus was measured. Absolute difference between V3 measurement by residents and experts was measured consecutively to assess the learning curve. Results Among the 100 patients included in the study, V3 diameter could be assessed in 87 patients (87%) from at least one side of the skull. Both temporal windows were available in 70 patients (70%). The ICC between V3 diameter measured by TCS and CT was 0.90 [95% CI 0.84–0.93] on the right side, and 0.92 [0.88–0.95] on the left side. In Bland–Altman analysis, mean difference, standard deviation, 95% limits of agreement were 0.36, 1.52, − 2.7 to 3.3 mm, respectively, on the right side; 0.25, 1.47, − 2.7 to 3.1 mm, respectively, on the left side. Among the 35 patients with hydrocephalus, V3 diameters could be measured by TCS in 31 patients (89%) from at least one side. Hydrocephalus was, respectively, excluded, confirmed, or inconclusive using TCS in 35 (40%), 25 (29%) and 27 (31%) of the 87 assessable patients. After 5 measurements, every resident reached a satisfactory measurement compared to the expert operator. Conclusion TCS allows rapid, simple and reliable V3 diameter measurement compared with the gold standard in neuro-ICU patients. Aside from sparing irradiating procedures and transfers to the radiology department, it may especially increase close patient monitoring to detect clinically occult hydrocephalus earlier. Further studies are needed to measure the potential clinical benefit of this method. Trial registration: ClinicalTrials.gov ID: NCT02830269.https://doi.org/10.1186/s13613-021-00857-xNeurocritical careThird ventricleSonographyHydrocephalusPoint of care |
| spellingShingle | Rémy Widehem Paul Bory Frédéric Greco Frédérique Pavillard Kévin Chalard Alexandre Mas Flora Djanikian Julie Carr Nicolas Molinari Samir Jaber Pierre-François Perrigault Gerald Chanques Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study Annals of Intensive Care Neurocritical care Third ventricle Sonography Hydrocephalus Point of care |
| title | Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study |
| title_full | Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study |
| title_fullStr | Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study |
| title_full_unstemmed | Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study |
| title_short | Transcranial sonographic assessment of the third ventricle in neuro-ICU patients to detect hydrocephalus: a diagnostic reliability pilot study |
| title_sort | transcranial sonographic assessment of the third ventricle in neuro icu patients to detect hydrocephalus a diagnostic reliability pilot study |
| topic | Neurocritical care Third ventricle Sonography Hydrocephalus Point of care |
| url | https://doi.org/10.1186/s13613-021-00857-x |
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