Use of transcranial Doppler ultrasound in the management of post-cardiac arrest syndrome

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

doi:10.1016/j.resuscitation.2009.07.011

Cited by 21 publications

(24 citation statements)

References 8 publications

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“…Another study in a rat model of asphyxia due to cardiac arrest showed varying degrees of cerebral blood flow depending on the region of the brain affected (cortical versus subcortical) and degree of insult (moderate versus severe) . Twenty‐four hours after resuscitation, others noted a diffuse hyperdynamic pattern, as evidenced by a high mean flow velocity and low pulsatility index, which is a pattern associated with a poor prognosis and increased intracranial pressure …”

Section: Discussionmentioning

confidence: 99%

Novel Quantitative Contrast‐Enhanced Ultrasound Detection of Hypoxic Ischemic Injury in Neonates and Infants: Pilot Study 1

Hwang

Sridharan

Darge

et al. 2018

J of Ultrasound Medicine

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Objectives To investigate whether quantitative contrast‐enhanced ultrasound (CEUS) can accurately identify neonates and infants with hypoxic ischemic brain injury. Methods In this prospective cohort study, 8 neonates and infants with a suspicion of hypoxic ischemic injury were evaluated with CEUS. Results An interesting trend was observed in the central gray nuclei–to–cortex perfusion ratios. The ratios at the peak enhancement, wash‐in area under the curve, perfusion index, and maximum wash‐in slopes were lower in all of the affected cases compared to the normal group but not statistically significant given the small sample size (P = .0571). Additionally, when the central gray nuclei–to–cortex perfusion ratio was plotted for all time points along the time‐intensity curve, it was observed that the affected cases showed a trend that was qualitatively different from that of the normal cases. In the affected cases, the ratio time‐intensity curves either stayed below 1.0 for the entire enhancement period or reached 1.0 close to peak wash‐in before falling just below 1.0 for the remaining period of enhancement. However, in the unaffected patients, there was a steep wash‐in that crossed the 1.0 threshold and remained above 1.0 for most of the enhancement period. Conclusions Bedside CEUS is an easily obtainable brain‐imaging modality that has the potential to effectively identify infants and neonates with evolving brain injury. A larger prospective study evaluating the correlation between CEUS findings and the reference standard of diffusion‐ and perfusion‐weighted magnetic resonance imaging is needed to establish it as a diagnostic tool.

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Section: Discussionmentioning

confidence: 99%

Novel Quantitative Contrast‐Enhanced Ultrasound Detection of Hypoxic Ischemic Injury in Neonates and Infants: Pilot Study 1

Hwang

Sridharan

Darge

et al. 2018

J of Ultrasound Medicine

View full text Add to dashboard Cite

show abstract

“…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%

“…4,5 Until recently, accurate measurements of cerebral blood flow have been restricted to complex techniques such as single-photon emission computed tomography or positron emission tomography. 6 Nevertheless, these techniques are not suitable for routine use in clinical practice. Transcranial Doppler ultrasonography (TCD), an easily applicable and bedside technique, allows for the measurement of blood flow velocities of the main cerebral arteries.…”

Section: Introductionmentioning

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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