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Applications of transcranial Doppler in the ICU: a review

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Abstract

Objective

Transcranial Doppler (TCD) ultrasonography is a technique that uses a hand-held Doppler transducer (placed on the surface of the cranial skin) to measure the velocity and pulsatility of blood flow within the intracranial and the extracranial arteries. This review critically evaluates the evidence for the use of TCD in the critical care population.

Discussion

TCD has been frequently employed for the clinical evaluation of cerebral vasospasm following subarachnoid haemorrhage (SAH). To a lesser degree, TCD has also been used to evaluate cerebral autoregulatory capacity, monitor cerebral circulation during cardiopulmonary bypass and carotid endarterectomies and to diagnose brain death. Technological advances such as M mode, colour Doppler and three-dimensional power Doppler ultrasonography have extended the scope of TCD to include other non-critical care applications including assessment of cerebral emboli, functional TCD and the management of sickle cell disease.

Conclusions

Despite publications suggesting concordance between TCD velocity measurements and cerebral blood flow there are few randomized controlled studies demonstrating an improved outcome with the use of TCD monitoring in neurocritical care. Newer developments in this technology include venous Doppler, functional Doppler and use of ultrasound contrast agents.

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Authors and Affiliations

  1. Department of Anaesthesia, Queen Elizabeth II Hospital, 4108, Coopers Plains, QLD, Australia

    Hayden White

  2. Department of Critical Care Medicine, University of Queensland, Princess Alexandra and Wesley Hospitals, 4102, Woollongabba, QLD, Australia

    Balasubramanian Venkatesh

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  1. Hayden White
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  2. Balasubramanian Venkatesh
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Correspondence to Balasubramanian Venkatesh.

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White, H., Venkatesh, B. Applications of transcranial Doppler in the ICU: a review. Intensive Care Med 32, 981–994 (2006). https://doi.org/10.1007/s00134-006-0173-y

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  • DOI: https://doi.org/10.1007/s00134-006-0173-y

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