Transcranial Doppler ultrasound in therapeutic hypothermia for cardiac arrest survivors

Álvarez-Fernández, Jesús A.; Pérez-Quintero, Raquel

doi:10.1097/ccm.0b013e3181ce495b

Cited by 3 publications

(6 citation statements)

References 6 publications

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“…If no complications occur, normal values should be reached after 72 h. 6,8 The pattern of loss of diastolic flow, appearance of retrograde diastolic flow, or no detectable flow in the cerebral arteries in TCD can be regarded as lethal signs which indicate cerebral circulatory arrest. 14-16 The persistence of these hypodynamic patterns are reliable indicators of a poor neurological prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…7 TCD examines the velocity and pulsatility of cerebral blood flow, making it possible to analyse the cerebral haemodynamic status. 6,8 The changes in mean blood flow velocities as visualised by TCD in the main cerebral arteries strongly reflects changes in the cerebral blood flow during http://dx.doi.org/10.1016/j.resuscitation.2015.01.029 0300-9572/© 2015 Elsevier Ireland Ltd. All rights reserved. cardiopulmonary resuscitation and following ROSC.…”

Section: Introductionmentioning

confidence: 99%

“…9 In addition, TCD does not interfere with therapeutic hypothermia or sedative support. 6,8 Only a few studies have reported on TCD as a neuromonitoring option during therapeutic hypothermia in children after resuscitation. Therefore, the aim of the present study was to assess cerebral blood flow in children receiving therapeutic hypothermia after resuscitation, and to estimate the prognostic value of TCD findings for the prediction of clinical outcomes in these children.…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation

et al. 2015

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“…La neuroprotección mediante hipotermia terapéutica a 32-34 1C, iniciada precozmente y mantenida durante 24 h, ha supuesto uno de los mayores avances en cuanto a la optimización de la recuperación neurológica tras la parada cardíaca y cambia radicalmente el pronóstico de pacientes que antes no habrían sobrevivido a este episodio o habrían quedado con graves secuelas 28 . Sin embargo, su aplicación correcta debe incluir una optimización hemodinámica que genera un incremento en el ya de por sí muy elevado consumo de recursos necesario para el tratamiento de estos pacientes en las UCI/UCC, y hace necesaria la disponibilidad de datos fiables para la monitorización y para el pronóstico de recuperación de estos pacientes 29 .…”

Section: Valor De La Ultrasonografía Doppler Transcraneal Tras La Recunclassified

Utilidad del Doppler transcraneal en la resucitación de la parada cardíaca

et al. 2010

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An effective tissue perfusion has decisive influence on the final prognosis both during cardiopulmonary resuscitation (CPR) and after recovery of spontaneous circulation (ROSC). The transcranial Doppler ultranosography (TCD) examines the velocity and pulsatility of cerebral blood flow, making it possible to perform "beat to beat" hemodynamic analysis. During CPR, TCD peak systolic velocity reflects cerebral perfusion of the chest compressions. Beyond 2 hours after ROSC, persistence in the cerebral arteries of a hemodynamic TCD pattern (low velocities with high pulsatilities) predicts poor neurological prognosis. Early or delayed presence of a hyperemic TCD pattern (high velocities with low pulsatilities) is associated conclusively with evolution to intracranial hypertension and its appearance during the rewarming process should lead to immediate return to therapeutic hypothermia. The coincidence of hypodynamic cerebral arteries and others with normal or hyperemic TCD patterns may indicate the presence of focal hypoperfusion that could predict stroke after ROSC.

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“…A patient's cerebral hemodynamic status after resuscitation can be determined using the pattern of Doppler spectral waveform, the pulsatility index (PI) and the mean flow velocity of the main cerebral arteries following TCD examination (9)(10)(11)(12). Using serial TCD examinations, changes in the Doppler spectral waveform, PI and mean flow velocity strongly reflect hemodynamic fluctuations during post-cardiac arrest care (10,11,(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

The Utility of a Point-of-Care Transcranial Doppler Ultrasound Management Algorithm on Outcomes in Pediatric Asphyxial Out-of-Hospital Cardiac Arrest – An Exploratory Investigation

et al. 2022

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BackgroundTranscranial Doppler ultrasound is a sensitive, real time tool used for monitoring cerebral blood flow; it could provide additional information for cerebral perfusion in cerebral resuscitation during post cardiac arrest care. The aim of the current study was to evaluate the utility of a point-of-care transcranial Doppler ultrasound management algorithm on outcomes in pediatric asphyxial out-of-hospital cardiac arrest.MethodsThis retrospective cohort study was conducted in two tertiary pediatric intensive care units between January 2013 and June 2018. All children between 1 month and 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions, who were treated with therapeutic hypothermia and survived for 12 h or more after the return of circulation were eligible for inclusion.ResultsTwenty-one patients met the eligibility criteria for the study. Sixteen (76.2%) of the 21 children were male, and the mean age was 2.8 ± 4.1 years. Seven (33.3%) of the children had underlying disorders. The overall 1-month survival rate was 52.4%. Twelve (57.1%) of the children received point-of-care transcranial Doppler ultrasound. The 1-month survival rate was significantly higher (p = 0.03) in the point-of-care transcranial Doppler ultrasound group (9/12, 75%) than in the non-point-of-care transcranial Doppler ultrasound group (2/9, 22.2%).ConclusionsPoint-of-care transcranial Doppler ultrasound group was associated with a significantly better 1-month survival rate compared with no point-of-care transcranial Doppler ultrasound group in pediatric asphyxial out-of-hospital cardiac arrest.

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Transcranial Doppler ultrasound in therapeutic hypothermia for cardiac arrest survivors

Cited by 3 publications

References 6 publications

Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation

Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation

Utilidad del Doppler transcraneal en la resucitación de la parada cardíaca

The Utility of a Point-of-Care Transcranial Doppler Ultrasound Management Algorithm on Outcomes in Pediatric Asphyxial Out-of-Hospital Cardiac Arrest – An Exploratory Investigation

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