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Child's Nervous System

, Volume 34, Issue 8, pp 1465–1470 | Cite as

Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review

  • Francisco Abecasis
  • Vitor Oliveira
  • Chiara Robba
  • Marek Czosnyka
Case-Based Update

Abstract

Purpose

Transcranial Doppler (TCD) has been used for more than 30 years in clinical practice. Although adult intensive care is relatively well covered, pediatric cases are still underrepresented. We intend to review a series of pediatric cases where TCD was determinant in clinical decisions and a literature review on this topic.

Methods

We describe cases with different pathologies where TCD had an important role in clinical management of the patients. We discuss TCD utility and potential role both in the emergency department and the intensive care unit.

Results

Five patients with different neurologic insults are presented. TCD was useful in the identification of intracranial hypertension in traumatic brain injury, hydrocephalus and central nervous system infection; identification of decreased cerebral perfusion pressure in hypovolemic shock and the diagnosis of impending cerebral circulatory arrest in a child with meningococcal septicemia. We discuss how TCD can be used in emergency and intensive care settings, reviewing relevant literature and our own experience.

Conclusions

Non-invasive testing using TCD can aid clinical decisions. More widespread use of this technique will allow for better care of children with neurologic insults.

Keywords

Transcranial Doppler Traumatic brain injury Intracranial hypertension Neuromonitoring 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric Intensive Care Unit, Centro Hospitalar Lisboa Norte, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
  2. 2.Department of Neurology, Centro Hospitalar Lisboa Norte, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
  3. 3.Anaesthesia and Intensive CareSan Martino Policlinico HospitalGenoaItaly
  4. 4.Division of Neurosurgery, Department of Clinical NeurosciencesAddenbrooke’s HospitalCambridgeUK
  5. 5.Institute of Electronic SystemsWarsaw University of TechnologyWarsawPoland

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