Největší neurointenzivní společností je americká NCS, která se sešla v první polovině října na Havaji. Nejvýraznější novinkou v oblasti neurominitorace byla pupilometrie amerického výrobce NEUROPTICS. Jen v posterové sekci se jí přímo dotýkalo 6 posterů. Zde naleznete jejich přehled s PDF kopií ke stažení.
Neurological Pupil index Predicts Neurological Outcome Early After Cardiac Arrest: An Observational Study (Maine Medical Center)
A low Neurological Pupil index predicted poor outcome 4-6 hours after resuscitation from cardiac arrest, and dropped to abnormal levels (<3) and to zero (reflecting a non-reactive pupil) more often in patients with poor outcomes. Additional research is needed to define potential confounders, optimal timing, and thresholds for different levels of neurological risk with pupillometry.
The Effect of Ambient Light Conditions on Quantitative Pupillometry Measurements in Healthy Subjects (Brigham and Women’s Hospitall; Harvard Medical School)
We found that ambient light levels impact pupil parameters in healthy subjects. However, changes in NPi are small and more consistent in varying lighting conditions than other metrics. Further testing of patients with poor pupil reactivity is necessary to determine if ambient light conditions could influence clinical assessment in the critically ill. Practitioners should standardize lighting conditions to maximize the reliability of their measurements.
Changes in Quantitative Pupillary Reaction During Diagnosis and Treatment of Symptomatic Intracranial Hypotension (Stanford University)
Impairment of the PLR, as measured by NPI, occurred during symptomatic IH and resolved after treatment. Because management of intracranial hyper- and hypotension differ markedly, our results emphasize the importance of evaluating the clinical context before attributing pupillary/NPI changes to increased ICP. Automated pupillometry provides a non-invasive, bedside tool for monitoring progression and treatment of intracranial hypotension.
Incongruence in Constriction Velocity and Neurological Pupil Index (UT Southwestern, OhioHealth Riverside Methodist Hospital)
Constriction velocity is highly dependent on size of the pupil. Further studies need to be undertaken to determine the sensitivity and specificity of abnormal NPi and CV in detecting pathological processes such as midline shift or 3rd nerve compression that effect pupillary reactivity.
Range of quantitative pupillometry measurements and its association with traditional metrics in the Neuro ICU(Massachusetts General Hospital; Brigham & Women’s Hospital)
The range of pupillary metrics varies among critically ill neurologic patients and correlates with GCS and ICP. Further study is needed to establish whether change in pupil metrics predict specific clinical events.
Serial Pupillometer Readings Predicting Intracranial Pressure Crisis in Neurocritical Care Patients(University Hospital, Ernlagen, Germany)
Our data suggest a relationship between non-invasively detected changes in NPi, CV or MCV and ICP-crisis. Yet, clinical benefit of these parameters is subject to future studies.