Transcranial Doppler Non-invasive Assessment of Intracranial Pressure, Autoregulation of Cerebral Blood Flow and Critical Closing Pressure during Orthotopic Liver Transplant

Cardim, Danilo; Robba, Chiara; Schmidt, Eric; Schmidt, Bernhard; Donnelly, Joseph E.; Klinck, John; Czosnyka, Marek

doi:10.1016/j.ultrasmedbio.2019.02.003

Cited by 13 publications

(4 citation statements)

References 38 publications

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“…2 . There are still no clear indications for TCD in the perioperative setting, but some authors have suggested its use during liver transplant for the detection of cerebral complications and in particular brain edema [ 12 ]. During pneumoperitoneum and the Trendelenburg position, TCD can also be considered for the detection of episodes of high intracra-nial pressure (ICP) [ 13 ] following increases in carbon dioxide (CO2) that can result in cerebral vasodilatation [ 14 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

The Importance of Neuromonitoring in Non Brain Injured Patients

2022

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This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2022. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2022 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901 .

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Section: Clinical Applicationsmentioning

confidence: 99%

The Importance of Neuromonitoring in Non Brain Injured Patients

2022

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“…In general, PI modifications occur when CPP is less than 70 mmHg2. At the moment when ICP is equal to diastolic systemic blood pressure, the blood velocity of diastolic flow reaches zero, characterizing the momentary absence of cerebral blood perfusion during the diastolic phase of the cardiac cycle [66].…”

Section: Intracranial Hypertensionmentioning

confidence: 99%

Management of Patients with Brain Injury Using Noninvasive Methods

Frigieri¹,

Rabelo²,

Nogueira³

et al. 2021

Advancement and New Understanding in Brain Injury

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In the last decades, the development of new noninvasive technologies in critical care allowed physicians to continuously monitor clinical parameters, aggregating important information that has been previously inaccessible or restricted due to the invasiveness of the existing techniques. The aim of this chapter is to present noninvasive methods in use on intensive care units (ICU) for brain injured patients monitoring, collaborating to the diagnosis and follow-up, aiding medical teams to achieve better outcomes.

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“…6, 7 MES have been detected in many different clinical conditions and growing evidence supports TCD monitoring during several interventional and surgical procedures, as cardiac or vascular surgery [8][9][10][11] or even in the multimodal monitoring of patients undergoing liver transplant. 12 Up to now, implications of MES detection are still largely unexplored. 13 Furthermore, TCD could be a pivotal tool to monitor patients admitted to Intensive Care Units (ICU) with traumatic brain injury (TBI).…”

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Transcranial Doppler Monitoring in Acute Neurovascular Care: a Feasibility and Safety Study

Salimbeni,

Kulyk,

Favruzzo

et al. 2024

Preprint

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Introduction: Transcranial Color Doppler (TCD) is currently the only non-invasive bedside tool capable of providing real-time information on cerebral hemodynamics. However, being operator dependent, TCD monitoring is not feasible in many institutions. Robotic assisted TCD (ra-TCD) was recently developed to overcome these constraints. The aim of this study was to evaluate the safety and feasibility of cerebral monitoring with a novel ra-TCD in acute neurovascular care. Methods: This is a two-center prospective study conducted between August 2021 and February 2022 at Padua University Hospital (Padua, Italy) and Kepler University Hospital (Linz, Austria). Adult patients with conditions impacting on cerebral hemodynamics or undergoing invasive procedures affecting cerebral hemodynamics were recruited for prolonged monitoring (> 30 minutes) of the middle cerebral artery (MCA) with a novel ra-TCD (NovaGuideTM Intelligent Ultrasound, NeuraSignal, Los Angeles, CA, USA). Manual TCD was also performed for comparison by an experienced operator. Feasibility and safety rates were recorded. Results: 92 patients [age: mean 68.5 years, range 36-91; gender: male 57 (62%)] were enrolled in the two centers: 54 in Padua, 38 in Linz. The exam was feasible in the majority of patients (85.9%); the head cradle design and its radiopacity hindered its use during carotid endarterectomy and mechanical thrombectomy. Regarding safety, only one patient (1.1%) reported a minor local edema due to prolonged probe pressure. Velocity values resulted similar between ra-TCD and manual TCD. Discussion: This novel ra-TCD showed an excellent safety and feasibility, and proved to be as reliable as manual TCD in detecting blood flow velocities. These findings support its wider use for cerebral hemodynamics monitoring in acute neurovascular care. However, further technical improvements are needed to expand the range of applicable settings.

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Transcranial Doppler Non-invasive Assessment of Intracranial Pressure, Autoregulation of Cerebral Blood Flow and Critical Closing Pressure during Orthotopic Liver Transplant

Cited by 13 publications

References 38 publications

The Importance of Neuromonitoring in Non Brain Injured Patients

The Importance of Neuromonitoring in Non Brain Injured Patients

Management of Patients with Brain Injury Using Noninvasive Methods

Robotic-Assisted Transcranial Doppler Monitoring in Acute Neurovascular Care: a Feasibility and Safety Study

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