Noninvasive screening for intracranial hypertension in children with acute, severe traumatic brain injury

O’Brien, Nicole; Maa, Tensing; Reuter‐Rice, Karin

doi:10.3171/2015.3.peds14521

Cited by 57 publications

(44 citation statements)

References 32 publications

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“…The use of diastolic FV as a relevant parameter is currently thriving in clinical practice, especially in intensive care. Authors have reported a reduction of CPP by rising ICP or decreasing systemic blood pressure in TBI (Trabold, Meyer, Blanot, Carli, & Orliaguet, ; Bouzat et al, ; O'Brien, Maa, & Reuter‐Rice, ; Ziegler, Cravens, Poche, Gandhi, & Tellez, ).…”

Section: Basic Methodsmentioning

confidence: 99%

Transcranial Doppler: a stethoscope for the brain‐neurocritical care use

Robba

Cardim

Sekhon

et al. 2017

J of Neuroscience Research

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Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside monitoring technique that can evaluate cerebral blood flow hemodynamics in the intracranial arterial vasculature. TCD allows assessment of linear cerebral blood flow velocity, with a high temporal resolution and is inexpensive, reproducible, and portable. The aim of this review is to provide an overview of the most commonly used TCD derived signals and measurements used commonly in neurocritical care. We describe both basic (flow velocity, pulsatility index) and advanced concepts, including critical closing pressure, wall tension, autoregulation, noninvasive intracranial pressure, brain compliance, and cerebrovascular time constant; we also describe the clinical applications of TCD to highlight their utility in the diagnosis and monitoring of cerebrovascular diseases as the "stethoscope for the brain."

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Section: Basic Methodsmentioning

confidence: 99%

Transcranial Doppler: a stethoscope for the brain‐neurocritical care use

Robba

Cardim

Sekhon

et al. 2017

J of Neuroscience Research

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“…Although the use of TCD in pediatric TBI is still considered experimental and it is not part of the standard of care, there is a growing body of literature. Most recent studies conducted using TCD in pediatric TBI have primarily focused on its use in the diagnosis of increased intracranial pressure, cerebral vasospasm, or hyperemia and trending of cerebral flow velocities (LaRovere & O’Brien, 2015; LaRovere, O’Brien & Tasker, 2015; O’Brien, Maa, Reuter-Rice, 2015; O’Brien, Maa, Yeates, 2015; O’Brien, Reuter-Rice, Khanna, Peterson & Quinto, 2010). …”

Section: Transcranial Doppler Ultrasoundmentioning

confidence: 99%

“…Yet when Figaji and his team examined the use of a PI of one to better predict increased ICP in children with severe TBI, they found PIs were unreliable non-invasive indicators. In a recent study PIs in children with severe TBI who had a PI threshold > 1.31 in the first 24 hours after injury had a higher association of increased ICP; thereafter, PI was not a trusted measure to solely manage ICP (O’Brien, Maa, & Reuter-Rice, 2015). …”

Section: Transcranial Doppler Ultrasoundmentioning

confidence: 99%

Transcranial Doppler Ultrasound Use in Pediatric Traumatic Brain Injury

Reuter‐Rice

2017

Journal of Radiology Nursing

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Transcranial Doppler ultrasound (TCD) is an inexpensive portable diagnostic tool commonly available within most healthcare systems. A team of trained individuals perform and interpret the test to inform patient care management. The benefit of TCD is well established in adult patients with traumatic brain injury. However, in children with TBI, it is still considered exploratory and its use is not a part of the standard of care. This article describes what TCD is, its use in children, and how TCD measurements apply to children and adolescents in an effort to establish criteria for the use of TCD for children with TBI. The benefit of TCD in pediatric TBI is illustrated by 2 cases of children who participated in a TBI research study. Early indications are that the use of TCD in pediatric cases of TBI may produce unexpected real-time data about the cerebral vasculature and circulation characteristics in children with TBI. Transcranial Doppler ultrasound has the potential for playing an informative diagnostic role in future pediatric TBI management. Ultimately the goal to promote best outcomes after a TBI requires insights into the multi-dynamic nature of the injury and TCD has the ability to support these efforts.

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“…To date, however, the published reports regarding the utility of these non-invasive techniques – particularly in children with severe TBI - have been limited. A recent report by O’Brien and colleagues demonstrated reasonable sensitivity and specificity of pulsatility index from the middle cerebral artery (measured by tCD) with intracranial hypertension - although the technique was not accurate enough to predict actual ICP values [5]. Similarly, Gwer and colleagues demonstrated some utility with the tympanic membrane displacement analyzer in comatose children from Kenya and children in idiopathic intracranial hypertension clinic in the UK [6].…”

mentioning

confidence: 99%