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Cerebral Blood Flow and Transcranial Doppler Sonography Measurements of CO(2)-Reactivity in Acute Traumatic Brain Injured Patients.

Reinstrup, Peter LU ; Ryding, Erik; Asgeirsson, Bogi; Hesselgard, Karin LU ; Undén, Johan LU and Romner, Bertil LU (2014) In Neurocritical Care 20(1). p.54-59
Abstract
BACKGROUND:

Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use. An alternative approach is to measure the CBF velocity using bedside, non-invasive, and transcranial Doppler (TCD) sonography. This study was performed to investigate if TCD is a useful alternative to CBF in patients with severe TBI.



METHOD:

CBF and TCD flow velocity measurements and cerebrovascular reactivity to hypocapnia were simultaneously evaluated in 27 patients with acute TBI.... (More)
BACKGROUND:

Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use. An alternative approach is to measure the CBF velocity using bedside, non-invasive, and transcranial Doppler (TCD) sonography. This study was performed to investigate if TCD is a useful alternative to CBF in patients with severe TBI.



METHOD:

CBF and TCD flow velocity measurements and cerebrovascular reactivity to hypocapnia were simultaneously evaluated in 27 patients with acute TBI. Measurements were performed preoperatively during controlled normocapnia and hypocapnia in patients scheduled for hematoma evacuation under general anesthesia.



MAIN FINDING AND CONCLUSION:

Although the lack of statistical correlation between the calculated reactivity indices, there was a significant decrease in TCD-mean flow velocity and a decrease in CBF with hypocapnia. CBF and TCD do not seem to be directly interchangeable in determining CO(2)-reactivity in TBI, despite both methods demonstrating deviation in the same direction during hypocapnia. TCD and CBF measurements both provide useful information on cerebrovascular events which, although not interchangeable, may complement each other in clinical scenarios. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Neurocritical Care
volume
20
issue
1
pages
54 - 59
publisher
Humana Press
external identifiers
  • pmid:22700360
  • wos:000331639400008
  • scopus:84894564877
ISSN
1541-6933
DOI
10.1007/s12028-012-9727-8
language
English
LU publication?
yes
id
de149ec6-ef51-442d-8dbc-7c17b500976d (old id 2859367)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22700360?dopt=Abstract
date added to LUP
2012-07-04 18:16:27
date last changed
2017-10-08 03:20:44
@article{de149ec6-ef51-442d-8dbc-7c17b500976d,
  abstract     = {BACKGROUND: <br/><br>
Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use. An alternative approach is to measure the CBF velocity using bedside, non-invasive, and transcranial Doppler (TCD) sonography. This study was performed to investigate if TCD is a useful alternative to CBF in patients with severe TBI. <br/><br>
<br/><br>
METHOD: <br/><br>
CBF and TCD flow velocity measurements and cerebrovascular reactivity to hypocapnia were simultaneously evaluated in 27 patients with acute TBI. Measurements were performed preoperatively during controlled normocapnia and hypocapnia in patients scheduled for hematoma evacuation under general anesthesia. <br/><br>
<br/><br>
MAIN FINDING AND CONCLUSION: <br/><br>
Although the lack of statistical correlation between the calculated reactivity indices, there was a significant decrease in TCD-mean flow velocity and a decrease in CBF with hypocapnia. CBF and TCD do not seem to be directly interchangeable in determining CO(2)-reactivity in TBI, despite both methods demonstrating deviation in the same direction during hypocapnia. TCD and CBF measurements both provide useful information on cerebrovascular events which, although not interchangeable, may complement each other in clinical scenarios.},
  author       = {Reinstrup, Peter and Ryding, Erik and Asgeirsson, Bogi and Hesselgard, Karin and Undén, Johan and Romner, Bertil},
  issn         = {1541-6933},
  language     = {eng},
  number       = {1},
  pages        = {54--59},
  publisher    = {Humana Press},
  series       = {Neurocritical Care},
  title        = {Cerebral Blood Flow and Transcranial Doppler Sonography Measurements of CO(2)-Reactivity in Acute Traumatic Brain Injured Patients.},
  url          = {http://dx.doi.org/10.1007/s12028-012-9727-8},
  volume       = {20},
  year         = {2014},
}