Pupil measurements added to American Heart Association guidance for brain injury prognosis

Updated American Heart Association Guidelines for CPR and Emergency Cardiovascular Care included the Neurological Pupil Index and automated pupillometry as an objective measure of brain injury prognosis after cardiac arrest.

Health care providers can assess pupillary light reflex with automated infrared pupillometry, according to a press release on the updated guidelines. The NPi-200 Pupillometer from NeurOptics, a medical technology company, measures pupil size and reactivity and calculates a patient’s neurological pupil index (NPi) value. NPi scores range from 0 to 4.9; scores under 3 are considered abnormal, according to the release.

“The NPi scale removes subjectivity from the neurological evaluation, providing clinicians with more accurate, objective and reliable pupil data that can be trended over time and allows earlier detection of changes for timelier patient treatment,” William Worthen, president and CEO of NeurOptics, said in the release.

According to the new guidelines from the American Heart Association, most deaths attributed to brain injury after cardiac arrest result from removal of life-sustaining treatment because of predictions for a poor neurological outcome. Automated evaluation of pupillary reactivity, as is done with the NPi scale, offers a standard way to examine pupil size and reactivity to inform a prognosis of a poor neurological outcome in patients who remain comatose 72 hours after cardiac arrest.