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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Frantz Rom Paulsen, University of Southern Denmark
- Second opponent: Associate Professor Elham Rostami, Uppsala University
- Third member and chair of the evaluation committee: Professor Kjetil Sunde, University of Oslo
Chair of the Defence
Professor Søren Pischke, University of Oslo
Principal Supervisor
Associate Professor Mads Aarhus, University of Oslo
Summary
Controlling intracranial pressure (ICP) is a central part of management of several neurosurgical conditions. This necessitates the measurement of ICP. In current practice, invasive ICP measurement remains the standard, but its invasiveness limits practical availability. Optic nerve sheath diameter (ONSD) is a promising parameter for non-invasive assessment of ICP that can be obtained by transorbital ultrasound.
In this project we evaluated two innovations related to using optic nerve sheath parameters in the non-invasive assessment of ICP. First, we evaluated a novel method of automated software-based measurements of ONSD. Second, we evaluated a novel optic nerve sheath parameter, named deformability index (DI).
Neuro-critically ill patients with invasive ICP monitoring, which served as the reference measurement, were included. In the first study, agreement between manual and automated ONSD measurements was evaluated. In the second study, diagnostic ability of DI, either when used alone, or when combined with ONSD was evaluated. In the third study, real-time automated ONSD measurements using a prototype ultrasound machine were evaluated.
Results showed that automated ONSD measurements displayed a reasonable agreement with manual measurements. DI displayed association with ICP individually, and combining DI and ONSD showed signs of increasing the association to ICP, compared to using ONSD alone. Real-time automated measurements of ONSD at the bedside using the prototype ultrasound machine correlated well with ICP and displayed an ability to discriminate high and low ICP.
Additional information
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