{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:22:47Z","timestamp":1787757767383,"version":"build-2784847793"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In brain injury patients, positive end-expiratory pressure (PEEP) may potentially increase the intracranial pressure (ICP). ICP can be noninvasively assessed from the sonographic measurement of the optic nerve sheath diameter (ONSD). Herein, we aim to evaluate the association between PEEP and ICP via measuring ONSD in traumatic brain injury (TBI) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      TBI patients with age \u226518 years, severe brain injury (GCS 8 or less), receiving mechanical ventilation, initial PEEP \u22644 mmHg and no history of severe cardiopulmonary disease were included in this study. Patients with intracranial hypertension (defined as ICP &gt;20 mmHg) and already receiving PEEP &gt;15 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O at enrollment were excluded from the study. ONSD measurement was performed when hemodynamic parameters were most stable. Variables included central venous pressure, invasive blood pressure, heart rate, saturation, and ventilator parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The ONSD and ICP did not increase significantly while PEEP increased from 0\u20135 cm and 5\u201310 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. However, ONSD and ICP significantly increased when PEEP increased from 10\u201315 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. There was no significant difference noted while comparing measurements of optic nerve sheath (ONS) diameter in both eyes at all PEE\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      values in cases as well as control patients. Mean arterial pressure (MAP) decreased with an increase in PEE\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value. Highly significant decrease occurred in MAP change from PEEP 10\u201315 in cases (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and control (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The PEEP up to 10 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O can be safely applied in patients with TBI. In addition, the increment of PEEP might further increase the oxygenation, at the cost of ICP accentuation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.333532","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:47:50Z","timestamp":1640656070000},"page":"1670-1674","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":15,"title":["Correlation of Positive End-Expiratory and Intracranial Pressure Using the Ultrasonographic-Guided Measurement of Optic Nerve Sheath Diameter in Traumatic Brain Injury Patients"],"prefix":"10.4103","volume":"69","author":[{"given":"Neha","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vipin 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