Use of an automated pupilometer after a stroke
Research type
Research Study
Full title
Use of an automated pupilometer to monitor for signs of early neurological deterioration after stroke – a feasibility study.
IRAS ID
223865
Contact name
Ali Ali
Contact email
Sponsor organisation
Sheffield Teaching Hospitals NHS FT
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Patients sustaining a variety of neurological injuries are at risk of raised intracranial pressure that can have harmful consequences, ranging from reductions in conscious level to severe brain herniation and resultant death. Serial measurement of pupillary reactivity has been a cornerstone of neurological assessment in such patients for many years. When performed accurately it can allow early detection of raised intracranial pressure and ensure rapid referral for intervention, however, the manual assessment of pupillary reactivity is highly subjective.
Automation of this assessment using a pupillometer (NPi-200) can standardise this process. It can quantitatively take 30 pictures per second of the pupil in response to light and calculates a neurological pupil index. There are no reports of this technology having been studied systematically in patients presenting with stroke. However, pupillary measurements are a standard part of neurological assessment in hyperacute stroke units as patients with both ischaemic and haemorrhagic stroke are at risk of cerebral oedema and neurological deterioration.
Standardisation of the pupillary assessment may help to ensure rapid detection of such complications and referral for interventions that are time critically dependent e.g. hemicraniectomy, blood product infusions, extra-ventricular drainage.
The majority of studies to date using the NPi have evaluated patients within the ITU setting with very low levels of consciousness. Thus we must first investigate whether this form of pupillary assessment is acceptable and feasible to undertake in the setting of a hyperacute stroke unit (HASU).
REC name
East Midlands - Derby Research Ethics Committee
REC reference
17/EM/0094
Date of REC Opinion
31 Mar 2017
REC opinion
Further Information Favourable Opinion