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

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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.

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Centro Hospitalar Lisboa Norte, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

    Francisco Abecasis

  2. Department of Neurology, Centro Hospitalar Lisboa Norte, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

    Vitor Oliveira

  3. Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRSSS for Oncology, Genoa, Italy

    Chiara Robba

  4. Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, UK

    Marek Czosnyka

  5. Institute of Electronic Systems, Warsaw University of Technology, Warsaw, Poland

    Marek Czosnyka

Authors
  1. Francisco Abecasis
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  2. Vitor Oliveira
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  3. Chiara Robba
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  4. Marek Czosnyka
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Corresponding author

Correspondence to Francisco Abecasis.

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

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Abecasis, F., Oliveira, V., Robba, C. et al. Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review. Childs Nerv Syst 34, 1465–1470 (2018). https://doi.org/10.1007/s00381-018-3877-8

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  • DOI: https://doi.org/10.1007/s00381-018-3877-8

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