NPi-300 Brochure References - NeurOptics
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NPi®-300 Brochure References

NPi®-300 Pupillometer System

The Next Generation in Automated Pupillometry

  • Pupillary changes are considered early indicators of neurological change and yet are often undetectable using traditional manual assessment methods.*

 

  • Manual pupillary assessment is subject to compounded sources of inaccuracies and inconsistencies and can result in as much as 39% inter-examiner variability and error.*
  • The NeurOptics NPi-300 Pupillometer is a handheld automated device that provides an accurate, reliable, and objective measurement of pupil size and reactivity.

 

  • Automated pupillometry is becoming accepted as best practice for pupillary assessment in patient care in any area of the hospital where a neurological exam is performed, including every ICU, the Emergency Department, Progressive Care Units, and more.
  • The Neurological Pupil index™, NPi®, quantifies pupil reactivity on a numeric scale from 0-4.9 (see NPi Pupil Reactivity Assessment Scale), so for the first time ever, reactivity can be trended over time just like other vital signs.

 

  • NPi is the only accurate and objective measurement of pupil reactivity in many common critical care scenarios, including in the presence of opioids, neuromuscular blocking agents (NMBA’s), and sedatives.*
  • There are now over 140 peer-reviewed research articles and scientific abstracts supporting the value of pupillometry and NPi in improving the quality of the neurological exam and enhancing clinical decision making and patient care.*

 

  • Pupillometry and NPi are included in several clinical reference texts and national guidelines.*

References

  1. Achamallah N, Fried J, Love R, Matusov Y, Sharma R. Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation. Journal of Intensive Care Medicine. Apr 2021;36(4):459-465.
  2. Al-Obaidi SZ, Atem FD, Stutzman SE, Olson DM. Impact of increased intracranial pressure on pupillometry: A replication study. Crit Care Explor. Oct 2019;1 (10): e0054.
  3. American Heart Association. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC. 2020.
  4. Berlin T, Cecil S, Olin K, Puccio A. Technology. In: Bader M, Littlejohns L, Olson D, eds. AANN Core Curriculum for Neuroscience Nursing. 6th ed. American Association of Neuroscience Nurses: 2016; 135-167,Chap 7.
  5. Chen JW, Gombart ZJ, Rogers S, Gardiner SK, Cecil S, Bullock RM. Pupillary reactivity as an early indicator of increased intracranial pressure: The introduction of the Neurological Pupil index. Surg Neurol Int. 2011;2:82.
  6. Du R, Meeker M, Bacchetti P, Larson MD, Holland MC, Manley GT. Evaluation of the portable infrared pupillometer. Neurosurgery. Jul 2005;57(1):198-203; discussion 198-203.
  7. Hickey JV, Strayer A. The Clinical Practice of Neurological and Neurosurgical Nursing. Eighth edition. Wolters Kluwer: 2020; pp168-170.
  8. Jolkovsky EL, Fernandez-Penny FE, Alexis M, Benson LN,Wang BH, Abella BS. Impact of acute intoxication on quantitative pupillometry assessment in the emergency department. JACEP Open. 2022;3:e12825.
  9. Kerr RG, Bacon AM, Baker LL, et al. Underestimation of pupil size by critical care and neurosurgical nurses. Am J Crit Care. 05 2016;25(3):213-9.
  10. Kim TJ, Park SH, Jeong HB, et al. Neurological Pupil index as an indicator of neurological worsening in large hemispheric strokes. Neurocrit Care. 102020;33(2):575-581.
  11. Larson M, Behrends M. Portable infrared pupillometry: a review. Anesth Analg. Jun 2015;120(6):1242-53.
  12. McKay RE, Larson MD. Detection of opioid effect with pupillometry. Autonomic Neuroscience. Aug 2021;235:102869.
  13. McNett M, Moran C, Grimm D, Gianakis A. Pupillometry trends in the setting of increased intracranial pressure. J Neurosci Nurs. Dec 2018;50(6):357-361.
  14. Meeker M, Du R, Bacchetti P, et al. Pupil examination: Validity and clinical utility of an automated pupillometer. J Neurosci Nurs.
  15. Miroz JP, Ben-Hamouda N, Bernini A, et al. Neurological Pupil index for early prognostication after venoarterial extracorporeal membrane oxygenation. Chest. May2020;157(5):1167-1174.
  16. Morelli P, Oddo M, Ben-Hamouda N. Role of automated pupillometry in critically ill patients. Minerva Anestesiol. Sep 2019;85(9):995-1002.
  17. Clinical Publications – Critical Care.
  18. Scientific Abstracts – Critical Care.
  19. Oddo M, Sandroni C, Citerio G, et al. Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: An international prospective multicenter double-blinded study. Intensive Care Med. Dec2018;44(12):2102-2111.
  20. Olson DM, Fishel M. The use of automated pupillometry in critical care. Crit CareNurs Clin North Am. Mar 2016;28(1):101-7.
  21. Olson DM, Stutzman S, Saju C, Wilson M, Zhao W, Aiyagari V. Interrater reliability of pupillary assessments. Neurocrit Care. Apr 2016;24(2):251-7.
  22. Privitera CM, Neerukonda SV, Aiyagari V, Yokobori S, Puccio AM, Schneider NJ, Stutzman SE, Olson DM, END PANIC Investigators: A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients. BMC Neurology, July 2022.
  23. Rasulo FA, Togni T, Romagnoli S. Essential noninvasive multimodality neuromonitoring for the critically ill patient. Crit Care. Mar 2020;24(1):100.
  24. Shoyombo I, Aiyagari V, Stutzman SE, et al. Understanding the relationship between the Neurologic Pupil index and constriction velocity values. Sci Rep. 05 2018;8(1):6992.
  25. Wiegand DJL-M, American Association of Critical-Care Nurses. AACN Procedure Manual for High-Acuity, Progressive, and Critical Care. 7th edition. Elsevier:2017;880-884.