Critical Care

Critical Care

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Pupillometry in Critical Care & Emergency Medicine

The NeurOptics® NPi™-100 Pupillometer removes subjectivity from pupil measurement

The NeurOptics® NPi™-100 Pupillometer is a hand-held, cordless, and simple to use device which removes subjectivity in the measurement of pupil size and the pupillary light reflex (PLR). Now even the smallest changes in pupillary function which are not discernable to the naked eye are detectable by clinicians and can be measured and quantified.




The NPi™-100 Pupillometer:

  • Accurately measures pupillary size, latency, constriction velocity, and dilation velocity;
  • The Neurological Pupil index™ (NPi™) algorithm grades the pupillary light reaction on a scale between 0 and 5, providing a number for clinicians to track and trend.
  • Requires no calibration by the user and is extremely easy to use;
  • Takes over 30 pictures per second of the pupil’s response to light stimulus;
  • Displays the reading in both numerical and graphic form;
  • Stores up to 3,000 readings on device;
  • Prints via infrared to portable printer for hard-copy documentation;

Click here for NPi™-100 Pupillometer Brochure.

Why measure the pupils of a critically injured or ill patient? (Please read our White Paper on Pupillometry in Neurocritical Care.)

Frequent pupil evaluation is part of the protocol for care of the critically injured or ill patient. The pupillary light reflex (PLR) and pupil size have traditionally been used as a clinical parameter and as a prognostic indicator. The Brain Trauma Foundation and the American Association of Neurological Surgeons recommends that pupillary light reflex for each eye should be used as a prognostic parameter and that the duration of pupillary dilation and fixation should be documented.

How is this measurement currently taken?

This assessment is currently performed by clinicians manually using a penlight and pupil gauge (Haab scale) which is a very subjective and qualitative measurement. In addition to critically ill or injured patients, the pupillometer can be used to facilitate measurement of pupil dynamics on patients who are on drugs (whether it be a drug overdose or morphine prescribed by doctors for pain related to the initial trauma.) In this case, the pupils are very constricted (a phenomenon known as "pin-point pupils") and it is difficult, if not impossible, to measure pupil dynamics with the naked eye.

The NPi™ scale provides a rigorous and automated metric for checking the pupils (See more detail on the NPi™ scale here.)

When clinicians score the pupils as part of the neurological evaluation of the patient, pupils are classified as "brisk" (i.e., normal), "sluggish" or "nonreactive," all of which are subjective terms. NeurOptics scientists have developed a model/algorithm based on many years of pupil research. This algorithm, called "NPi™" or "neurological pupil index," removes subjectivity from pupil scoring by giving the clinician a numerical NPi™ value between 0 and 5. An NPi™ value equal to or greater than 3 is considered a "normal" pupillary reaction as defined by the NeurOptics algorithm, and an NPi™ value below 3 is considered an "abnormal" pupillary reaction.

Find more information at the NeurOptics® University.

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See who else is using the NPi™-100 Pupillometer and what they have to say about it.

Product Training & Support

Clinical Resources

We can also provide literature resources, quick reference sheets, sample protocols and competency checklists.

 

The NPi™-100 Pupillometer, which was featured on the cover of the Journal of Neurosurgery in an article entitled "Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury," can easily and objectively measure the pupillary light reflex of the critically ill or injured patient.

What some current Pupillometer users have to say about the device:

We have five units in our ICU. The nurses use it routinely to track pupillary changes. It is extremely helpful both for documentation and also to detect any early changes that could lead to early interventions (i.e., CT scans and subsequent surgery).

— Dr. Jefferson Chen, Director of Neurotrauma, Legacy Health Systems.

Our neuro/critical care team has found the pupillometer has added another dimension to our clinical assessment by providing objective data on pupillary response. By trending constriction velocity and ICP, we have enhanced our clinical decision making at the bedside. The pupillometer has consistently provided accurate data on pupillary response.

— Mary Kay Bader, Neuroscience Clinical Nurse Specialist, Mission Regional Medical Center and Brain Trauma Foundation Medical Advisory Board Member.

The pupillometer has really helped in the assessment of critical changes in our TBI patients.

— Barbie Cilento, Clinical Nurse Specialist, Intensive Care Unit National Naval Medical Center, Bethesda

It's great! The new equipment for the modern neurologist...

— Stephan A. Mayer, MD, FCCM, Director, Neurological Intensive Care Unit New York Presbyterian Hospital/Columbia President, Neurocritical Care Society

REFERENCES