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Sepsis in the ICU: Usefulness of Transcranial Doppler (TCD/TCCS) to Cerebral Hemodynamic Monitoring

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Neurosonology in Critical Care

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Abstract

Sepsis-associated encephalopathy (SAE) is common during sepsis and is associated with poor outcome and long-term cognitive sequelae. Altered cerebral autoregulation (CA) may lead to suboptimal cerebral perfusion, which may contribute to the development of SAE. CA may be investigated by transcranial Doppler (TCD/TCCS). Modifications in cerebral circulation have been investigated in humans affected by sepsis and SAE with controversial results. Data suggest that CA may be impaired early during the course of sepsis and associated with both severity of inflammatory syndrome and neurological dysfunction. However, to date, studies investigating cerebral hemodynamics in large cohort of septic patients are lacking. Furthermore, comparability of the results in published literature is difficult because of the variety of methods in CA assessment. Whether cerebrovascular resistance and reactivity to carbon dioxide are affected during sepsis is not clear. Therapeutic strategies based on optimization of cerebral perfusion using TCD may be of interest in clinical practice.

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Author information

Authors and Affiliations

  1. Department of Intensive Care, University of Brussels, Erasme Hospital, Brussels, Belgium

    Ilaria Alice Crippa

  2. Emergency Medicine, University Libre of Brussels, Brussels, Belgium

    Fabio Silvio Taccone

  3. Department of Intensive Care, Laboratory of Experimental Research, Erasme Hospital, Brussels, Belgium

    Fabio Silvio Taccone

Authors
  1. Ilaria Alice Crippa
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  2. Fabio Silvio Taccone
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Corresponding author

Correspondence to Fabio Silvio Taccone .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Buenos Aires, Buenos Aires, Argentina

    Camilo N. Rodríguez

  2. Stroke Unit & Neurosonology Lab, University of Padua School of Medicine, Padova, Italy

    Claudio Baracchini

  3. Department of Critical Care and Anesthesiology, Fundación Valle del Lili, Cali, Colombia

    Jorge H. Mejia-Mantilla

  4. Department of Clinical Neurosciences Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK

    Marek Czosnyka

  5. Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jose I Suarez

  6. President of Hungarian Neurological Society, Department of Neurology, Clinical Center Debrecen University, Debrecen, Hungary

    László Csiba

  7. Intensive Care Unit, Clinics Hospital, Universidad de la Republica School of Medicine, Montevideo, Uruguay

    Corina Puppo

  8. Center for Neurological Vascular Diagnostics, Munich, Germany

    Eva Bartels

Algorithm

Algorithm

figure a

ABCD Airway-breathing-circulation-disability, CNS Central nervous system, MAP Mean arterial pressure, SpO2 peripheral capillary Oxygen saturation, pCO2 Carbon dioxide arterial partial pressure, ScvO2 Central venous oxygen saturation, SvO2 Mixed venous oxygen saturation

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Crippa, I.A., Taccone, F.S. (2022). Sepsis in the ICU: Usefulness of Transcranial Doppler (TCD/TCCS) to Cerebral Hemodynamic Monitoring. In: Rodríguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_51

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  • DOI: https://doi.org/10.1007/978-3-030-81419-9_51

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81418-2

  • Online ISBN: 978-3-030-81419-9

  • eBook Packages: MedicineMedicine (R0)

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