{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:37:36Z","timestamp":1785213456338,"version":"3.55.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100016003","name":"Istanbul University Cerrahpa\u015fa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100016003","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>In general, high levels of PEEP application is avoided in patients undergoing craniotomy to prevent a rise in ICP. But that approach would increase the risk of secondary brain injury especially in hypoxemic patients. Because the optic nerve sheath is distensible, a rise in ICP is associated with an increase in the optic nerve sheath diameter (ONSD). The cutoff value for elevated ICP assessed by ONSD is between 5.6 and 6.3\u00a0mm. We aimed to evaluate the effect of different PEEP levels on ONSD and compare the effect of different PEEP levels in patients with and without intracranial midline shift.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This prospective observational study was performed in aged 18\u201370\u00a0years, ASA I\u2013III, 80 patients who were undergoing supratentorial craniotomy. After the induction of general anesthesia, the ONSD\u2019s were measured by the linear transducer from 3\u00a0mm below the globe at PEEP values of 0\u20135\u201310 cmH<jats:sub>2<\/jats:sub>O. The ONSD were compered between patients with (<jats:italic>n<\/jats:italic>\u2009=\u20097) and without midline shift (<jats:italic>n<\/jats:italic>\u2009=\u200973) at different PEEP values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The increases in ONSD due to increase in PEEP level were determined (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). No difference was found in the comparison of ONSD between patients with and without midline shift in different PEEP values (<jats:italic>p<\/jats:italic>\u2009=\u20090.329, 0.535, 0.410 respectively). But application of 10 cmH<jats:sub>2<\/jats:sub>O PEEP in patients with a midline shift increased the mean ONSD value to 5.73\u00a0mm. This value is roughly 0.1\u00a0mm higher than the lower limit of the ONSD cutoff value.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The ONSD in adults undergoing supratentorial tumor craniotomy, PEEP values up to 5 cmH<jats:sub>2<\/jats:sub>O, appears not to be associated with an ICP increase; however, the ONSD exceeded the cutoff for increased ICP when a PEEP of 10 cmH<jats:sub>2<\/jats:sub>O was applied in patients with midline shift.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00701-024-06067-1","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T17:01:30Z","timestamp":1713200490000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of different positive end expiratory pressure levels on optic nerve sheath diameter in patients with or without midline shift who are undergoing supratentorial craniotomy"],"prefix":"10.1007","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3740-0170","authenticated-orcid":false,"given":"Adem","family":"Fenerci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-2265","authenticated-orcid":false,"given":"Eren Fatma","family":"Akcil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6742-0128","authenticated-orcid":false,"given":"Yusuf","family":"Tunali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5221-0144","authenticated-orcid":false,"given":"Ozlem Korkmaz","family":"Dilmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"issue":"1","key":"6067_CR1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s12028-019-00853-x","volume":"32","author":"R Aspide","year":"2020","unstructured":"Aspide R, Bertolini G, Albini Riccioli L, Mazzatenta D, Palandri G, Biasucci DG (2020) A proposal for a new protocol for sonographic assessment of the optic nerve sheath diameter: the CLOSED protocol. 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The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"We obtained informed consent from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"177"}}