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Ratio of optic nerve sheath diameter to eyeball transverse diameter in cardiac arrest survivors
  1. Dean-An Ling1,
  2. Jia-Yu Chen1,
  3. Yi-Chu Chen2,
  4. Ying-Chih Ko1,
  5. Chih-Heng Chang1,
  6. Wan-Ching Lien1,
  7. Wei-Tien Chang1,
  8. Chien-Hua Huang1
  1. 1 Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
  2. 2 Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
  1. Correspondence to Dr Wan-Ching Lien, Emergency Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan; wanchinglien{at}

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Optic nerve sheath diameter (ONSD) is associated with poor neurological outcomes following resuscitation.1 2 However, the cut-off values of ONSD vary and are similar to those of normal adults.2 3 The ratio of ONSD to eyeball transverse diameter (ETD) would be a better indicator for intracranial hypertension.4 However, the performance of the ONSD/ETD ratio in cardiac arrest survivors has not been studied. We conducted a prospective age-matched and sex-matched nested case–control study to investigate the performance of sonographic ONSD and ONSD/ETD ratio between out-of-hospital cardiac arrest (OHCA) survivors with good and poor outcomes compared with healthy controls.

Consecutive adult non-traumatic OHCA survivors between March 2020 and February 2021 and healthy controls were prospectively enrolled. Those with prior ophthalmological operations and a history of a brain tumour or brain surgery were excluded. Each OHCA survivor was matched to four controls by age and sex. This study was registered at (NCT04510363).

The sonographic examinations were performed at 24, 72 and 168 hours post-return of spontaneous circulation (ROSC) (for survivors) or study enrolment (controls). Three measurements were taken at each time point and averaged. The ONSD was measured between the outer hyperechoic borders of the optic nerve sheath at 3 …

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  • Handling editor Richard Body

  • Contributors D-AL and W-CL conceived the study and designed the trial. W-CL, W-TC and C-HH supervised the conduct of the trial and data collection. J-YC, Y-CC, Y-CK and C-HH undertook data collection and managed the data, including quality control. D-AL and W-CL analysed the data. D-AL drafted the manuscript and W-CL revised it. All authors contributed substantially to its revision. W-CL takes responsibility for the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.