RESUMEN
INTRODUCTION: The objective of the study was to analyse the correlation between extracorporeal life support (ECLS) and aortic cross-clamp times and optic nerve sheath diameter (ONSD). PATIENTS AND METHODS: Study in a cohort of patients aged 0-15 years that underwent ECLS for cardiac surgery after obtention of signed informed consent. We calculated a sample size of 23 participants. First, we obtained 3 vertical and 3 horizontal measurements of the ONSD for each eye and calculated the mean of both eyes for each measurement to be used in the analysis. The measurements were made at admission and at 6 and 24â¯h post surgery. We retrieved the ECLS time and the aortic cross-clamp time were from the operative report. RESULTS: We analysed data for 23 participants, 52.2% female, with a median age of 14 months. The median ECLS time was 60â¯min; the median aortic cross-clamp time was 32â¯min. The median baseline ONSD was 3.1â¯mm. ONSD values had increased a median of 0.015â¯mm at 6â¯h post surgery (Pâ¯=â¯.03). We found a positive correlation between ECLS time and ONSD values (râ¯=â¯0.476, Pâ¯<â¯0,05). The ONSD values returned to baseline by 24â¯h post surgery. None of the patients developed signs or symptoms of increased intracranial pressure. CONCLUSION: Our study found a correlation between ECLS time and ONSD at 24â¯h post surgery. We found variations in the ONSD even in patients without signs or symptoms of increased ICP. Further research is required to identify the factors related to these variations.
Asunto(s)
Oxigenación por Membrana Extracorpórea , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Presión Intracraneal/fisiología , Masculino , Nervio Óptico/diagnóstico por imagen , Estudios Prospectivos , UltrasonografíaRESUMEN
Introducción: El objetivo de este estudio es establecer la correlación entre los tiempos de circulación extracorpórea (CEC) y pinzamiento aórtico y el diámetro de la vaina del nervio óptico (DVNO). Pacientes y métodos: Se estudió una cohorte de pacientes con edad de 0 a 15 años, sometidos a cirugía cardíaca con CEC. Se calculó un tamaño muestral de 23 participantes. Primero se obtuvo el promedio de tres mediciones verticales y tres horizontales del DVNO. Después, se utilizó para los análisis la media de los valores de ambos ojos. Las mediciones ocurrieron al ingreso y a las 6 y 24 horas poscirugía. Los tiempos de CEC y pinzamiento aórtico se obtuvieron del informe quirúrgico. Resultados: Se analizaron datos de 23 participantes, el 52,2% mujeres, con edad mediana de 14 meses. La mediana del tiempo de CEC fue 60 minutos; la mediana de tiempo de pinzamiento aórtico fue 32 minutos. La mediana del DVNO basal fue 3,1mm. Los valores de DVNO aumentaron por una mediana de 0,015mm a las 6 horas poscirugía (p=0,03). Encontramos una correlación positiva entre el tiempo de CEC y los valores de DVNO (r=0,476; p<0,05). Los valores de DVNO regresaron al valor basal a las 24 horas poscirugía. Ningún paciente desarrolló signos o síntomas de incremento de la presión intracraneal. Conclusión: El estudio encontró una correlación entre el tiempo de CEC y el DVNO medido 24 horas poscirugía. Hubo variaciones del DVNO incluso en pacientes sin signos o síntomas de incremento de la presión intracraneal. Se requiere más investigación para identificar los factores relacionados con estas variaciones. (AU)
Introduction: The objective of the study was to analyse the correlation between extracorporeal life support (ECLS) and aortic cross-clamp times and optic nerve sheath diameter (ONSD). Patients and methods: Study in a cohort of patients aged 0 to 15 years that underwent ECLS for cardiac surgery after obtention of signed informed consent. We calculated a sample size of 23 participants. First, we obtained 3 vertical and 3 horizontal measurements of the ONSD for each eye and calculated the mean of both eyes for each measurement to be used in the analysis. The measurements were made at admission and at 6 and 24hours post surgery. We retrieved the ECLS time and the aortic cross-clamp time were from the operative report. Results: We analysed data for 23 participants, 52.2% female, with a median age of 14 months. The median ECLS time was 60minutes; the median aortic cross-clamp time was 32minutes. The median baseline ONSD was 3.1mm. ONSD values had increased a median of 0.015mm at 6hours post surgery (P=.03). We found a positive correlation between ECLS time and ONSD values (r=0.476, p<,05). The ONSD values returned to baseline by 24hours post surgery. None of the patients developed signs or symptoms of increased intracranial pressure. Conclusion: Our study found a correlation between ECLS time and ONSD at 24hours post surgery. We found variations in the ONSD even in patients without signs or symptoms of increased increased intracranial pressure. Further research is required to identify the factors related to these variations. (AU)
Asunto(s)
Humanos , Recién Nacido , Preescolar , Niño , Adolescente , Circulación Extracorporea , Aorta/lesiones , Nervio Óptico , Cirugía Torácica , Correlación de DatosRESUMEN
INTRODUCTION: The objective of the study was to analyse the correlation between extracorporeal life support (ECLS) and aortic cross-clamp times and optic nerve sheath diameter (ONSD). PATIENTS AND METHODS: Study in a cohort of patients aged 0 to 15 years that underwent ECLS for cardiac surgery after obtention of signed informed consent. We calculated a sample size of 23 participants. First, we obtained 3 vertical and 3 horizontal measurements of the ONSD for each eye and calculated the mean of both eyes for each measurement to be used in the analysis. The measurements were made at admission and at 6 and 24hours post surgery. We retrieved the ECLS time and the aortic cross-clamp time were from the operative report. RESULTS: We analysed data for 23 participants, 52.2% female, with a median age of 14 months. The median ECLS time was 60minutes; the median aortic cross-clamp time was 32minutes. The median baseline ONSD was 3.1mm. ONSD values had increased a median of 0.015mm at 6hours post surgery (P=.03). We found a positive correlation between ECLS time and ONSD values (r=0.476, p<,05). The ONSD values returned to baseline by 24hours post surgery. None of the patients developed signs or symptoms of increased intracranial pressure. CONCLUSION: Our study found a correlation between ECLS time and ONSD at 24hours post surgery. We found variations in the ONSD even in patients without signs or symptoms of increased increased intracranial pressure. Further research is required to identify the factors related to these variations.