A Scoping Review of Cerebral Doppler Arterial Waveforms in Infants

Continuous monitoring of cerebral blood flow during general anaesthesia in infants

“…The reduction in end-diastolic velocity in our patients may indicate reduced cerebral perfusion as end-diastolic velocity is the most sensitive marker of haemodynamic changes. 22 , 26 The same pattern is also seen in other pathological conditions, such as haemodynamically significant patent ductus arteriosus, asphyxia, and sepsis. 22 By contrast, the reduction in end-diastolic velocity may also indicate increased peripheral resistance.…”

“… 22 , 26 The same pattern is also seen in other pathological conditions, such as haemodynamically significant patent ductus arteriosus, asphyxia, and sepsis. 22 By contrast, the reduction in end-diastolic velocity may also indicate increased peripheral resistance. 30 , 31 However, the less marked reduction in peak systolic velocity and the significant decrease in time-averaged maximum velocity are consistent with our interpretation that the observed decrease in end-diastolic velocity indicates reduced CBF.…”

“… 21 As indicators of cerebral haemodynamics, peak systolic velocity is considered to mainly reflect systemic factors, such as cardiac output and systolic blood pressure, whereas end-diastolic velocity is the most sensitive marker to changes in cerebral haemodynamics, such as changes in peripheral resistance and diastolic blood pressure. 22 Time-averaged maximum velocity is considered to be directly related to cerebral perfusion, 23 and an increase in time-averaged maximum velocity may be explained by increased blood pressure or reduced peripheral resistance. NIRS was used to measure regional cerebral oxygenation.…”

Transcranial Doppler: A New Stethoscope–Voiceover Tool for Neonatal Brain

“…13 The RI in the ACA drops from a mean of 0.78 (range 0.65-0.85) in preterm infants to 0.7 (range 0.6-0.8) in the full-term neonates. [14][15][16][17][18] The increase in diastolic flow with postnatal age may result from decreasing cerebrovascular resistance or diminishing shunting as a result of ductal closure. Further, these data relate to the known downward trend of the RI during the first year after birth, especially after the closure of fontanelle when the mean RI decreases between 0.5 and 0.6.…”

Continuous cerebral blood flow monitoring: What should we do with these extra numbers?

“…The gold standard of noninvasive cerebral haemodynamic monitoring in neonates is the transfontanellar cerebral Doppler. 18 , 19 The NeoDoppler highlighted by Vik and colleagues 1 builds on this and has many advantages. This small noninvasive device allows continuous measurement of cerebral perfusion in infants with an open fontanelle.…”