Journal of Korean Neurosurgical Society

  • 제58권4호
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  • Pages.363-367
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  • 2015
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Clinical Utility of an Automated Pupillometer in Patients with Acute Brain Lesion

  • Park, Jeong Goo (Department of Neurosurgery, Konkuk University Medical Center) ;
  • Moon, Chang Taek (Department of Neurosurgery, Konkuk University Medical Center) ;
  • Park, Dong Sun (Department of Neurosurgery, Konkuk University Medical Center) ;
  • Song, Sang Woo (Department of Neurosurgery, Konkuk University Medical Center)
  • 투고 : 2015.07.07
  • 심사 : 2015.10.14
  • 발행 : 2015.10.28
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초록

Objective : The purpose of this study was to evaluate the clinical utility and validity of using a pupillometer to assess patients with acute brain lesions. Methods : Pupillary examinations using an automated pupillometer ($NeurOptics^{(R)}NPi^{TM}$-100 Pupillometer) were performed every 4 hours and were simultaneously assessed using the Glasgow Coma Scale (GCS) and for intracranial pressure (ICP), from admission to discharge or expire in neuro-intensive care unit (NICU). Manual pupillary examinations were also recorded for comparison. By comparing these data, we evaluated the validity of using automated pupillometers to predict clinical outcomes. Results : The mean values of the Neurologic Pupillary index (NPi) were different in the groups examined manually. The GCS correlated well with NPi values, especially in severe brain injury patients (GCS below 9). However, the NPi values were weakly correlated with intracranial pressure (ICP) when the ICP was lower than 30 cm $H_2O$. The NPi value was not affected by age or intensity of illumination. In patients with a "poor" prognosis who had a Glasgow Outcome Scale (GOS) of 1 or 2, the mean initial NPi score was $0.88{\pm}1.68$, whereas the value was $3.89{\pm}0.97$ in patients with a "favorable" prognosis who had a GOS greater than 2 (p<0.001). For predicting clinical outcomes, the initial NPi value of 3.4 had the highest sensitivity and specificity. Conclusion : An automated pupillometer can serve as a simple and useful tool for the accurate measurement of pupillary reactivity in patients with acute brain lesions.

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참고문헌

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피인용 문헌

  1. Optical pupillometry in traumatic brain injury: neurological pupil index and its relationship with intracranial pressure through significant event analysis vol.33, pp.8, 2019, https://doi.org/10.1080/02699052.2019.1605621
  2. A Systematic Review Assessing the Current State of Automated Pupillometry in the NeuroICU vol.31, pp.1, 2019, https://doi.org/10.1007/s12028-018-0645-2
  3. Automated Pupillometry in Neurocritical Care: Research and Practice vol.19, pp.10, 2019, https://doi.org/10.1007/s11910-019-0994-z
  4. Comparison of 2 Automated Pupillometry Devices in Critically III Patients vol.32, pp.4, 2020, https://doi.org/10.1097/ana.0000000000000604
  5. Early Pupillometry Assessment in Traumatic Brain Injury Patients: A Retrospective Study vol.11, pp.12, 2021, https://doi.org/10.3390/brainsci11121657