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CASE REPORT
Year : 2018  |  Volume : 62  |  Issue : 11  |  Page : 892-895

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


1 Department of Anaesthesiology, Indraprastha Apollo Hospitals, New Delhi, India
2 Apollo LT and HPB Surgery, Indraprastha Apollo Hospitals, New Delhi, India

Correspondence Address:
Dr. Atish Pal
Department of Anaesthesiology, Indraprastha Apollo Hospitals, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_104_18

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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.


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