The clinical implications for detection of any abnormality have been firmly established in terms of neurological outcome, morbidity, and mortality. Automated quantitative pupillometry is a more reliable method with which to collect pupillary measurements at the bedside.Įvaluation of pupil size and its light reflex mechanism is an integral part of the protocol for the treatment and management of severely brain-injured patients in ICUs worldwide. Standard practice in pupillary monitoring yields inaccurate data. For measurements with small pupils (diameters <2 mm) the error rate was 39 % (24/61). A global rate of discordance of 18 % (72/406) was found between the two techniques when assessing the pupillary light reflex. Nursing staff failed to diagnose half of the cases (15/30) of anisocoria detected using the pupillometer device. Concordance between measurements for pupil size collected using the pupillometer, versus subjective assessment, was poor (Spearmen's rho = 0.75, IC: 0.70-0.79 P < 0.001). In 59 patients, 406 pupillary measurements were prospectively performed. The mean pupil light reactivity was 40 ± 7 %. We found only 3-pupil asymmetry (≥1 mm) in these volunteers (1.5 % of the population) with a clear pupil asymmetry during clinical inspection. In 200 healthy volunteers, intra-class correlation coefficient for maximum resting pupil size was 0.95 (IC: 0.93-0.97) and for minimum pupil size after light stimulation 0.87 (0.83–0.89). A blinded physician subsequently performed measurement using an automated pupillometer. Initially, nursing staff measured pupil size, anisocoria and pupillary light reflex.

Patients admitted to these units after an acute brain injury were included. During another period, we conducted a prospective, observational, double-blinded study in two neurocritical care units.

In order to determine inter-observer agreement of the device, we performed repetitive measurements in 200 healthy volunteers ranging in age from 21 to 58 years, providing a total of 400 paired (alternative right eye, left eye) measurements under a wide variety of ambient light condition with NeuroLight Algiscan pupillometer. To assess whether adoption of these technologies would benefit the clinic, we compared automated quantitative pupillometry with the standard clinical pupillary examination currently used for brain-injured patients. Several quantitative pupillometer devices are now available, although their use is primarily restricted to the research setting. The result seems to be a subjective measurement, with low precision and reproducibility. Current practice is to use a penlight to observe the pupillary light reflex. In critical care units, pupil examination is an important clinical parameter for patient monitoring.

Nvr double pupil