Perioperative monitoring of intracranial pressure using optic nerve sheath diameter in paediatric liver transplantation

An elevation of intracranial pressure (ICP) secondary to cerebral oedema is a major contributor to morbidity and mortality in acute liver failure (ALF). We present a case of ICP monitoring with ocular ultrasonography in a 2-year-old child with ALF for liver transplantation. Since invasive ICP monito...

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Bibliographic Details
Main Authors: Atish Pal, Purnima Dhar, Neerav Goyal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2018-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:http://www.ijaweb.org/article.asp?issn=0019-5049;year=2018;volume=62;issue=11;spage=892;epage=895;aulast=Pal
Description
Summary:An elevation of intracranial pressure (ICP) secondary to cerebral oedema is a major contributor to morbidity and mortality in acute liver failure (ALF). We present a case of ICP monitoring with ocular ultrasonography in a 2-year-old child with ALF for liver transplantation. Since invasive ICP monitoring was risky considering the level of coagulopathy, optic nerve sheath diameter (ONSD) monitoring was done by ultrasound. A value of 4.5 mm was chosen as the cut-off for an ICP >20 mmHg in this child and was checked at regular intervals during the surgery. Ultrasonographic ONSD assessment can be a useful modality in liver transplant recipients, with severe coagulopathy and high ICP. In our specific patient scenario, ocular ultrasound proved to be a valuable safe and noninvasive monitoring tool in this paediatric patient.
ISSN:0019-5049
0976-2817