Automated pupillometer for monitoring the critically ill patient: A critical appraisal

Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a comput...

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Vydané v:	Journal of critical care Ročník 29; číslo 4; s. 599 - 603
Hlavní autori:	Zafar, Sahar F., Suarez, Jose I.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Elsevier Inc 01.08.2014 Elsevier Limited
Predmet:	Adult Automated pupillometer Automation Cardiopulmonary resuscitation Coma CPR Critical Care Critical Illness Diagnosis, Computer-Assisted - instrumentation Diagnostic Techniques, Ophthalmological - instrumentation Digital cameras Humans Intensive care Intensive Care Units Intervention Iris - pathology Light Male Medical prognosis Neurocritical care Organ Size Prognosis Pupil Disorders - diagnosis Reflex, Pupillary - physiology Reproducibility of Results Studies United States > US Critical care Automated pupillometer Neurocritical care
ISSN:	0883-9441, 1557-8615, 1557-8615
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Abstract	Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry.
AbstractList	Abstract Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry. Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry. Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry. 15 references Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry.Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination is confounded by interobserver discrepancies and errors in detecting a reflex under certain conditions. The automated pupillometer is a computer-based infrared digital video device that can obtain objective measurements of pupillary size and reactivity. We performed an electronic literature search to identify original studies on the use of the automated pupillometer in the ICU. We identified 7 articles that met the inclusion criteria and reviewed them critically and assessed the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation approach. We found that the study grade was low, and study quality was low to moderate for all the reviewed manuscripts. Pupillometric measurements had better precision and reproducibility compared with the manual pupillary examination. Based on these data, we conclude that pupillometry monitoring can serve as an important tool in the ICU. Further large scale studies on patients in the neurocritical care unit and medical ICU are needed to support the routine use of automated pupillometry.
Author	Suarez, Jose I. Zafar, Sahar F.
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Snippet	Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary examination... Abstract Abnormalities in the pupillary light reflex are an important prognostic indicator for patients in the intensive care unit (ICU). Manual pupillary...
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SubjectTerms	Adult Automated pupillometer Automation Cardiopulmonary resuscitation Coma CPR Critical Care Critical Illness Diagnosis, Computer-Assisted - instrumentation Diagnostic Techniques, Ophthalmological - instrumentation Digital cameras Humans Intensive care Intensive Care Units Intervention Iris - pathology Light Male Medical prognosis Neurocritical care Organ Size Prognosis Pupil Disorders - diagnosis Reflex, Pupillary - physiology Reproducibility of Results Studies
Title	Automated pupillometer for monitoring the critically ill patient: A critical appraisal
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