Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review

Abecasis, Francisco; Oliveira, Vítor; Robba, Chiara; Czosnyka, Marek

doi:10.1007/s00381-018-3877-8

Cited by 14 publications

(9 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the final documents reached unanimous agreement by the group. 63-5.9 y 147 (17) 144 (19) 104 (22) 81 (16) 88 96-9.9 y 143 (13) 140 (14) 100 (20) 75 (10) 85 1710-18 y 129 (17) 125 (18) 92 (19) 66 (10) 68 (11) Mean flow velocity a : Abbreviations: ACA, anterior cerebral artery; BA, basilar artery; ICA, internal carotid artery; MCA, middle cerebral artery; PCA, posterior cerebral artery; SD, standard deviation; TCD, transcranial Doppler ultrasonography. a Mean flow velocity ¼ time mean of the maximal velocity envelope curve.…”

Section: Limitationsmentioning

confidence: 99%

Practice Recommendations for Transcranial Doppler Ultrasonography in Critically Ill Children in the Pediatric Intensive Care Unit: A Multidisciplinary Expert Consensus Statement

O’Brien

Reuter‐Rice

Wainwright

et al. 2020

J Pediatr Intensive Care

View full text Add to dashboard Cite

Transcranial Doppler ultrasonography (TCD) is being used in many pediatric intensive care units (PICUs) to aid in the diagnosis and monitoring of children with known or suspected pathophysiological changes to cerebral hemodynamics. Standardized approaches to scanning protocols, interpretation, and documentation of TCD examinations in this setting are lacking. A panel of multidisciplinary clinicians with expertise in the use of TCD in the PICU undertook a three-round modified Delphi process to reach unanimous agreement on 34 statements and then create practice recommendations for TCD use in the PICU. Use of these recommendations will help to ensure that high quality TCD images are captured, interpreted, and reported using standard nomenclature. Furthermore, use will aid in ensuring reproducible and meaningful study results between TCD practitioners and across PICUs.

show abstract

Section: Limitationsmentioning

confidence: 99%

Practice Recommendations for Transcranial Doppler Ultrasonography in Critically Ill Children in the Pediatric Intensive Care Unit: A Multidisciplinary Expert Consensus Statement

O’Brien

Reuter‐Rice

Wainwright

et al. 2020

J Pediatr Intensive Care

View full text Add to dashboard Cite

show abstract

“…The ow dynamics of intracranial arterial blood are assessed by transcranial Doppler (TCD) and the physiological parameters of blood ow by the ultrasonic Doppler effect [9,10]. Distal ow in the posterior circulation is a robust indicator of the risk of vertebrobasilar artery stroke in patients with symptomatic atherosclerotic vertebrobasilar artery occlusive disease [11].…”

Section: Transcranial Doppler Combined With Quantitative Electroencepmentioning

confidence: 99%

Transcranial Doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction

Cao

Song

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Posterior circulation cerebral infarction (PCCI) leads to decreased cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional CBF both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) can evaluate neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate its efficacy in predicting the prognosis of patients with PCCI.Methods: We used TCD-QEEG to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta+theta)/(alpha+beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Results: Forty patients (aged 63.7±9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD (hazards ratio [HR] 0.168, confidence interval [CI] 0.047–0.597, p=0.006), and QEEG indicators of DTABR (HR 12.527, CI 1.637–95.846, p=0.015) were the independent predictors of the clinical outcomes. The AUROC after the combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p<0.05).Conclusion: TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.

show abstract

“…Finally, transcranial Doppler ultrasound has been utilized for continuous cerebral monitoring in adult and pediatric patients. 24,25 However, this technique is hampered by several limitations and is not suitable in a bedside neonatal clinical setting.…”

Section: New Features Obtained With Neodopplermentioning

confidence: 99%

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: There is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure cerebral blood flow velocity continuously in different depths of the brain simultaneously. We aimed to study the feasibility, accuracy, and potential clinical applications of NeoDoppler in preterm infants and sick neonates. METHOD: Twenty-five infants born at different gestational ages with a variety of diagnoses on admission were included. The probe was placed over the anterior fontanel, and blood flow velocity data were continuously recorded. To validate NeoDoppler, we compared the measurements with conventional ultrasound; agreement was assessed using Bland-Altman plots. RESULTS: NeoDoppler can provide accurate and continuous data on cerebral blood flow velocity in several depths simultaneously. Limits of agreement between the measurements obtained with the two methods were acceptable. CONCLUSION: By monitoring the cerebral circulation continuously, increased knowledge of cerebral hemodynamics in preterm infants and sick neonates may be acquired. Improved monitoring of these vulnerable brains during a very sensitive period of brain development may contribute toward preventing brain injuries.

show abstract

Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review

Abstract: Non-invasive testing using TCD can aid clinical decisions. More widespread use of this technique will allow for better care of children with neurologic insults.

Cited by 14 publications

References 26 publications

Practice Recommendations for Transcranial Doppler Ultrasonography in Critically Ill Children in the Pediatric Intensive Care Unit: A Multidisciplinary Expert Consensus Statement

Practice Recommendations for Transcranial Doppler Ultrasonography in Critically Ill Children in the Pediatric Intensive Care Unit: A Multidisciplinary Expert Consensus Statement

Transcranial Doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

Contact Info

Product

Resources

About