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Clinical applications of transcranial Doppler in non-trauma critically ill children: a scoping review

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Abstract

Background

Many applications of transcranial Doppler (TCD) as a diagnosis or monitoring tool have raised interest in the last decades. It is important that clinicians know when and how to perform TCD in this population, what parameter to assess and monitor and how to interpret it.

Objective

This review aims to describe the emerging clinical applications of TCD in critically ill children excluding those suffering from trauma.

Methods

Databases Web of Science, Cochrane and PubMed were searched in May 2020. We considered all publications since the year 2000 addressing the use of TCD as a prognostic, diagnostic or follow-up tool in children aged 0 to 15 years admitted to intensive care or emergency units, excluding neonatology and traumatic brain injury. Two independent reviewers selected 82 abstracts and full-text articles from the 2011 unique citations identified at the outset.

Results

TCD provides crucial additional information at bedside about cerebrovascular hemodynamics. Many clinical applications include the diagnosis and management of various medical and surgical neurologic conditions (central nervous system infections, arterial ischemic stroke, subarachnoid hemorrhage and vasospasm, brain death, seizures, metabolic disease, hydrocephalus) as well as monitoring the impact systemic conditions on brain perfusion (hemodynamic instability, circulatory assistance).

Conclusion

To conclude, TCD has become an invaluable asset for non-invasive neuromonitoring in critically ill children excluding those suffering from trauma. However, the scope of TCD remains unclearly defined yet and reference values in critically ill children are still lacking.

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Abbreviations

CBF:

Cerebral blood flow

PICU:

Pediatric intensive care unit

PvCO2 :

Venous carbon dioxide pressure

SAH:

Subarachnoid hemorrhage

TCD:

Transcranial Doppler

VD :

End-diastolic velocity

VM :

Mean velocity

VS :

Peak systolic velocity

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France

    Anne Millet, Amélie Desrumaux & Guillaume Mortamet

  2. Department of Anesthesia and Intensive Care, Grenoble-Alpes University Hospital, Grenoble, France

    Jean-Noël Evain, Gilles Francony & Pierre Bouzat

Authors
  1. Anne Millet
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  2. Jean-Noël Evain
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  3. Amélie Desrumaux
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  4. Gilles Francony
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  5. Pierre Bouzat
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  6. Guillaume Mortamet
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Contributions

AM, JNE, AD, and GM analyzed the data. GF, PB, and GM wrote the manuscript, which was approved by all the authors.

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Correspondence to Guillaume Mortamet.

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Millet, A., Evain, JN., Desrumaux, A. et al. Clinical applications of transcranial Doppler in non-trauma critically ill children: a scoping review. Childs Nerv Syst 37, 2759–2768 (2021). https://doi.org/10.1007/s00381-021-05282-w

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  • DOI: https://doi.org/10.1007/s00381-021-05282-w

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