Intracranial pressure and optic nerve sheath diameter as cephalic venous pressure increases in swine

Derek M. Nusbaum*, Jonathan B. Clark, Kenneth Martin Brady, Kathleen K. Kibler, Jeffrey P. Sutton, R. Blaine Easley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Nontraumatic, nonhydrocephalic increases in intracranial pressure (ICP) are often difficult to diagnose and may underlie spaceflight-related visual changes. This study looked at the utility of a porcine animal model of increasing cephalic venous pressure to mimic acute changes in ICP and optic nerve sheath diameter (ONSD) from cephalic venous fluid shifts observed during spaceflight. Methods: Anesthetized juvenile piglets were assigned to groups of either naïve (N 5 10) or elevated superior vena cava pressure (SVCP; N 5 20). To elevate SVCP, a 6F custom latex balloon catheter was inserted and inflated to achieve SVCP of 20 and 40 mmHg for 1 h at each pressure. In both groups, serial measurements of ICP, internal jugular pressure (IJP), and external jugular pressure (EJP) were made hourly for 3 h, and ONSD of the right eye was measured hourly by ultrasound (US). Results: There was a significant linear correlation between IJP and ICP (slope: 0.9614 6 0.0038, r 5 0.9683). With increasing SVCP, resulting ONSD was also well correlated with the ICP (slope: 0.0958 6 0.0061, r 5 0.7841). The receiver operating characteristic curve for ONSD in diagnosing elevated ICP had an area under the curve of 0.9632 with a sensitivity and specificity of 92% and 91%, respectively, for a cutoffof 5.45 mm. Conclusions: Increases in SVCP result in ICP changes that are well correlated with alteration in ONSD. These changes are consistent with observed ONSD changes monitored during spaceflight.

Original languageEnglish (US)
Pages (from-to)946-951
Number of pages6
JournalAviation Space and Environmental Medicine
Volume84
Issue number9
DOIs
StatePublished - 2013

Keywords

  • Spaceflight
  • Superior vena cava pressure
  • Ultrasound
  • Visual changes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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