Open AccessPerioperative monitoring of intracranial pressure using optic nerve sheath diameter in paediatric liver transplantation
Author(s) -
Atish Pal,
Purnima Dhar,
Neerav Goyal
Publication year - 2018
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/ija.ija_104_18
Subject(s) - medicine , intracranial pressure , intracranial pressure monitoring , liver transplantation , coagulopathy , perioperative , optic nerve , ultrasonography , ultrasound , transplantation , surgery , anesthesia , radiology , ophthalmology
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.