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

Peter Reinstrup, Erik Ryding, Bogi Asgeirsson, Karin Hesselgard, Johan Undén, Bertil Romner

Research output: Contribution to journalArticlepeer-review

6 Citations (SciVal)

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. 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.
Original languageEnglish
Pages (from-to)54-59
JournalNeurocritical Care
Volume20
Issue number1
DOIs
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Neurology
  • Anesthesiology and Intensive Care

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