• Changshin Kang, Jin Hong Min, Jung Soo Park, Yeonho You, Insool Yoo, Yong Chul Cho, Wonjoon Jeong, Hong Joon Ahn, Seung Ryu, Jinwoong Lee, Seung Whan Kim, Sung Uk Cho, Se Kwang Oh, In Ho Lee, Byungkook Lee, Donghun Lee, and Minjung Kathy Chae.
• Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea.
• Resuscitation. 2019 Dec 1; 145: 43-49.

AimStudies on the prognostic performance of optic nerve sheath diameter (ONSD) in out-of-hospital cardiac arrest survivors (OHCA) have reported conflicting results. We aimed to investigate the usefulness of ONSD measured using magnetic resonance imaging (MRI) to estimate its association with intracranial pressure (ICP) and 6-month neurological outcomes in CA survivors treated with targeted temperature management (TTM).MethodThis retrospective study included 37 CA survivors who underwent TTM from January 2018 to December 2018. ICP was measured by lumbar catheter during TTM on Days 0, 1, 2, and 3. ONSD was measured using MRI on Days 0 and 3. The primary outcome was the correlation between ONSD and ICP associated with neurological outcomes obtained after 6 months.ResultsThe median (interquartile range [IQR]) ONSD was not significantly different between the good and poor neurological outcome group on Day 0 (5.2 mm [4.8-5.8] vs 5.2 mm [4.8-5.6]; p = 0.948) and Day 3 (5.0 mm [4.8-5.2] vs 5.5 mm [4.4-5.9]; p = 0.105). ONSD and ICP had excellent correlation on Day 3 (r = 0.90, p < 0.001). ONSD showed excellent correlation with increased ICP (IICP) defined as ICP above 20 mmHg (r = 0.89, p < 0.001). ONSD cut-off of 5.99 mm was used with a sensitivity of 90.0% and specificity of 98.0% to identify IICP.ConclusionThe ONSD on Days 0 or 3 did not show differences in neurological outcomes in OHCA patients treated with TTM. However, ONSD had an excellent correlation with ICP on Day 3 and with IICP. Further studies are required to confirm our results.Copyright © 2019 Elsevier B.V. All rights reserved.

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