Book contents
- Neuroprognostication in Critical Care
- Neuroprognostication in Critical Care
- Copyright page
- Epigraph
- Contents
- Contributors
- Chapter 1 Shared Decision Making
- Part I Disease-Specific Prognostication
- Part II Other Topics in Neuroprognostication
- Chapter 18 Prognostication in Palliative Care and Neurocritical Care
- Chapter 19 Prognostication in Chronic Critical Illness: Frailty, Geriatrics, Prior Severe Neurological Comorbidities
- Chapter 20 Prognostication in the Transition of Neurocritical Care: Neurorehabilitation and Placement, Role of Post-ICU Recovery Clinics, Insurance, Case Management
- Chapter 21 Religious and Legal Issues in Neuroprognostication
- Chapter 22 New Frontiers in Neuroprognostication: Machine Learning and AI
- Chapter 23 New Frontiers in Neuroprognostication: Biomarkers
- Chapter 24 New Frontiers in Neuroprognostication: Point-of-Care Ultrasonography
- Index
- References
Chapter 24 - New Frontiers in Neuroprognostication: Point-of-Care Ultrasonography
from Part II - Other Topics in Neuroprognostication
Published online by Cambridge University Press: 14 November 2024
Book contents
- Neuroprognostication in Critical Care
- Neuroprognostication in Critical Care
- Copyright page
- Epigraph
- Contents
- Contributors
- Chapter 1 Shared Decision Making
- Part I Disease-Specific Prognostication
- Part II Other Topics in Neuroprognostication
- Chapter 18 Prognostication in Palliative Care and Neurocritical Care
- Chapter 19 Prognostication in Chronic Critical Illness: Frailty, Geriatrics, Prior Severe Neurological Comorbidities
- Chapter 20 Prognostication in the Transition of Neurocritical Care: Neurorehabilitation and Placement, Role of Post-ICU Recovery Clinics, Insurance, Case Management
- Chapter 21 Religious and Legal Issues in Neuroprognostication
- Chapter 22 New Frontiers in Neuroprognostication: Machine Learning and AI
- Chapter 23 New Frontiers in Neuroprognostication: Biomarkers
- Chapter 24 New Frontiers in Neuroprognostication: Point-of-Care Ultrasonography
- Index
- References
Summary
Clinical examination is central to prognostication in acute brain injury but it has its limitations, especially in presence of confounders like sedation, recent cardiac arrest or lack of access to full exam due to concomitant injuries.[1–3] Lack of robust clinical prognostication tools has allowed the possibility of scenarios where clinicians may withdraw care prematurely due to a presumed poor prognosis based on a poor neurological exam.[4] Conversely, clinicians may defer prognostication in a confounded neurological exam and maintain patients on advanced life support for days before the degree of neurological injury becomes manifest.[5] In some of these scenarios, cerebral hemodynamic evaluation using transcranial Doppler (TCD) may provide a noninvasive surrogate to assess cerebral perfusion and augment available information to aid in prognostication.
Introduced in 1982 as a noninvasive means of assessing cerebral blood flow by measuring velocities in intracranial vasculature, TCD has become a mainstay for evaluation of cerebrovascular hemodynamics in stroke and subarachnoid hemorrhage.[6]
- Type
- Chapter
- Information
- Neuroprognostication in Critical Care , pp. 328 - 339Publisher: Cambridge University PressPrint publication year: 2024
References
Sandroni, C, Cariou, A, Cavallaro, F, et al. Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Resuscitation 2014;85(12):1779–89.CrossRefGoogle ScholarPubMed
Samaniego, EA, Mlynash, M, Caulfield, AF, Eyngorn, I, Wijman, CA. Sedation confounds outcome prediction in cardiac arrest survivors treated with hypothermia. Neurocrit Care 2011;15(1):113–119.CrossRefGoogle ScholarPubMed
Greer, DM, Yang, J, Scripko, PD, et al. Clinical examination for prognostication in comatose cardiac arrest patients. Resuscitation 2013;84(11):1546–51.CrossRefGoogle ScholarPubMed
Geocadin, RG, Callaway, CW, Fink, EL, et al. Standards for studies of neurological prognostication in comatose survivors of cardiac arrest: a scientific statement from the American Heart Association. Circulation 2019;140(9):e517–e542.CrossRefGoogle ScholarPubMed
Lorusso, R. Extracorporeal life support and neurologic complications: still a long way to go. J Thorac Dis 2017;9(10):e954–e956.CrossRefGoogle Scholar
Aaslid, R, Markwalder, TM, Nornes, H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982;57(6):769–74.CrossRefGoogle ScholarPubMed
Yang, Q, Tong, X, Schieb, L, et al. Vital signs: recent trends in stroke death rates – United States, 2000–2015. MMWR Morbid Mortal Wkly Rep 2017;66(35):933–9.Google ScholarPubMed
Centers for Disease Control and Prevention. Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths – United States, 2014. US Department of Health and Human Services, 2019. Available at: www.cdc.gov/traumaticbraininjury/pdf/TBI-Surveillance-Report-FINAL_508.pdf.Google Scholar
Sinha, N, Parnia, S. Monitoring the brain after cardiac arrest: a new era. Curr Neurol Neurosci Rep 2017;17(8):62.CrossRefGoogle ScholarPubMed
Lim, C, Alexander, MP, LaFleche, G, Schnyer, DM, Verfaellie, M. The neurological and cognitive sequelae of cardiac arrest. Neurology 2004;63(10):1774–8.CrossRefGoogle ScholarPubMed
Benjamin, EJ, Blaha, MJ, Chiuve, SE, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation 2017;135(10):e146–e603.CrossRefGoogle ScholarPubMed
Howard, G, Goff, DC. Population shifts and the future of stroke: forecasts of the future burden of stroke. Ann N Y Acad Sci 2012;1268:14–20.CrossRefGoogle ScholarPubMed
Ovbiagele, B, Goldstein, LB, Higashida, RT, et al. Forecasting the future of stroke in the United States: a policy statement from the American Heart Association and American Stroke Association. Stroke 2013;44(8):2361–75.CrossRefGoogle ScholarPubMed
Macdonald, RL, Schweizer, TA. Spontaneous subarachnoid haemorrhage. Lancet 2017;389(10069):655–66.CrossRefGoogle ScholarPubMed
Findlay, JM, Nisar, J, Darsaut, T. Cerebral vasospasm: a review. Can J Neurol Sci 2016 43(1):15–32.CrossRefGoogle ScholarPubMed
Munoz-Sanchez, MA, Murillo-Cabezas, F, Egea-Guerrero, JJ, et al. [Emergency transcranial doppler ultrasound: predictive value for the development of symptomatic vasospasm in spontaneous subarachnoid hemorrhage in patients in good neurological condition]. Med Intensiva 2012;36(9):611–18.Google ScholarPubMed
Mascia, L, Fedorko, L, terBrugge, K, et al. The accuracy of transcranial Doppler to detect vasospasm in patients with aneurysmal subarachnoid hemorrhage. Intensive Care Med 2003;29(7):1088–94.CrossRefGoogle ScholarPubMed
Rigamonti, A, Ackery, A, Baker, AJ. Transcranial Doppler monitoring in subarachnoid hemorrhage: a critical tool in critical care. Can J Anaesth 2008;55(2):112–23.CrossRefGoogle ScholarPubMed
Lau, VI, Arntfield, RT. Point-of-care transcranial Doppler by intensivists. Crit Ultrasound J 2017;9(1):21.CrossRefGoogle ScholarPubMed
Connolly, ES Jr, Rabinstein, AA, Carhuapoma, JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2012;43(6):1711–37.CrossRefGoogle ScholarPubMed
Kumar, G, Shahripour, RB, Harrigan, MR. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Neurosurg 2016;124(5):1257–64.CrossRefGoogle ScholarPubMed
Schmidt, B, Gunawardene, M, Krieg, D, et al. A prospective randomized single-center study on the risk of asymptomatic cerebral lesions comparing irrigated radiofrequency current ablation with the cryoballoon and the laser balloon. J Cardiovasc Electrophysiol 2013;24(8):869–74.CrossRefGoogle Scholar
Lang, EW, Diehl, RR, Mehdorn, HM. Cerebral autoregulation testing after aneurysmal subarachnoid hemorrhage: the phase relationship between arterial blood pressure and cerebral blood flow velocity. Crit Care Med 2001;29(1):158–63.CrossRefGoogle ScholarPubMed
D’Andrea, A, Conte, M, Scarafile, R, et al. Transcranial Doppler ultrasound: physical principles and principal applications in neurocritical care unit. J Cardiovasc Echogr 2016;26(2):28–41.CrossRefGoogle ScholarPubMed
Pinto, VL, Tadi, P, Adeyinka, A. Increased Intracranial Pressure. StatPearls. Treasure Island (FL): StatPearls Publishing, 2020.Google Scholar
Marinoni, M, Cianchi, G, Trapani, S, et al. Retrospective analysis of transcranial doppler patterns in veno-arterial extracorporeal membrane oxygenation patients: feasibility of cerebral circulatory arrest diagnosis. Asaio J 2018;64(2):175–82.CrossRefGoogle ScholarPubMed
Ducrocq, X, Hassler, W, Moritake, K, et al. Consensus opinion on diagnosis of cerebral circulatory arrest using Doppler-sonography: task force group on cerebral death of the Neurosonology Research Group of the World Federation of Neurology. J Neurol Sci 1998;159(2):145–50.CrossRefGoogle Scholar
Chang, JJ, Tsivgoulis, G, Katsanos, AH, Malkoff, MD, Alexandrov, AV. Diagnostic accuracy of transcranial Doppler for brain death confirmation: systematic review and meta-analysis. Am J Neuroradiol 2016;37(3):408–14.CrossRefGoogle ScholarPubMed
Xu, B, Qiao, Q, Chen, M, et al. Relationship between neurological complications, cerebrovascular and cerebral perfusion following off-pump coronary artery bypass grafting. Neurol Res 2015;37(5):421–6.CrossRefGoogle ScholarPubMed
van Dijk, D, Spoor, M, Hijman, R, et al. Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery. JAMA 2007;297(7):701–8.CrossRefGoogle ScholarPubMed
Palmerini, T, Savini, C, Di Eusanio, M. Risks of stroke after coronary artery bypass graft – recent insights and perspectives. Interv Cardiol 2014;9(2):77–83.CrossRefGoogle Scholar
Thudium, M, Heinze, I, Ellerkmann, RK, Hilbert, T. Cerebral function and perfusion during cardiopulmonary bypass: a plea for a multimodal monitoring approach. Heart Surg Forum 2018;21(1):E028–E035.CrossRefGoogle ScholarPubMed
Bismuth, J, Garami, Z, Anaya-Ayala, JE, et al. Transcranial Doppler findings during thoracic endovascular aortic repair. J Vasc Surg 2011;54(2):364–9.CrossRefGoogle ScholarPubMed
Russell, D, Brucher, R. Embolus detection and differentiation using multifrequency transcranial Doppler. Stroke 2006;37(2):340–1; author reply 341–2.CrossRefGoogle ScholarPubMed
Dittrich, R, Ringelstein, EB. Occurrence and clinical impact of microembolic signals (MES) in patients with chronic cardiac diseases and atheroaortic plaques–a systematic review. Curr Vasc Pharmacol 2008;6(4):329–34.CrossRefGoogle ScholarPubMed
Melmed, KR, Schlick, KH, Rinsky, B, et al. Assessing cerebrovascular hemodynamics using transcranial Doppler in patients with mechanical circulatory support devices. J Neuroimaging 2020;30(3):297–302.CrossRefGoogle ScholarPubMed
Salna, M, Ikegami, H, Willey, JZ, et al. Transcranial Doppler is an effective method in assessing cerebral blood flow patterns during peripheral venoarterial extracorporeal membrane oxygenation. J Card Surg 2019;34(6):447–52.CrossRefGoogle ScholarPubMed
O’Brien, NF, Hall, MW. Extracorporeal membrane oxygenation and cerebral blood flow velocity in children. Pediatr Crit Care Med 2013;14(3):e126–34.CrossRefGoogle ScholarPubMed
Bazan, R, Luvizutto, GJ, Braga, GP, et al. Relationship of spontaneous microembolic signals to risk stratification, recurrence, severity, and mortality of ischemic stroke: a prospective study. Ultrasound J 2020;12(1):6.CrossRefGoogle ScholarPubMed
Dahl, A, Lindegaard, KF, Russell, D, et al. A comparison of transcranial Doppler and cerebral blood flow studies to assess cerebral vasoreactivity. Stroke 1992;23(1):15–19.CrossRefGoogle ScholarPubMed
Wolf, ME. Functional TCD: regulation of cerebral hemodynamics – cerebral autoregulation, vasomotor reactivity, and neurovascular coupling. Front Neurol Neurosci 2015;36:40–56.CrossRefGoogle ScholarPubMed
Silvestrini, M, Vernieri, F, Pasqualetti, P, et al. Impaired cerebral vasoreactivity and risk of stroke in patients with asymptomatic carotid artery stenosis. JAMA 2000;283(16):2122–7.CrossRefGoogle ScholarPubMed
Yonas, H, Smith, HA, Durham, SR, Pentheny, SL, Johnson, DW. Increased stroke risk predicted by compromised cerebral blood flow reactivity. J Neurosurg 1993;79(4):483–9.CrossRefGoogle ScholarPubMed
Gur, AY, Bova, I, Bornstein, NM. Is impaired cerebral vasomotor reactivity a predictive factor of stroke in asymptomatic patients? Stroke 1996;27(12):2188–90.CrossRefGoogle ScholarPubMed
Silvestrini, M, Viticchi, G, Falsetti, L, et al. The role of carotid atherosclerosis in Alzheimer’s disease progression. J Alzheimers Dis 2011;25(4):719–26.CrossRefGoogle ScholarPubMed
Wessels, T, Harrer, JU, Jacke, C, Janssens, U, Klotzsch, C. The prognostic value of early transcranial Doppler ultrasound following cardiopulmonary resuscitation. Ultrasound Med Biol 2006;32(12):1845–51.CrossRefGoogle ScholarPubMed
Rafi, S, Tadie, JM, Gacouin, A, et al. Doppler sonography of cerebral blood flow for early prognostication after out-of-hospital cardiac arrest: DOTAC study. Resuscitation 2019;141: 188–94.CrossRefGoogle ScholarPubMed
Lemiale, V, Huet, O, Vigue, B, et al. Changes in cerebral blood flow and oxygen extraction during post-resuscitation syndrome. Resuscitation 2008;76(1):17–24.CrossRefGoogle ScholarPubMed
Blumenstein, J, Kempfert, J, Walther, T, et al. Cerebral flow pattern monitoring by transcranial Doppler during cardiopulmonary resuscitation. Anaesth Intensive Care 2010;38(2):376–80.CrossRefGoogle ScholarPubMed
Lewis, LM, Gomez, CR, Ruoff, BE, et al. Transcranial Doppler determination of cerebral perfusion in patients undergoing CPR: methodology and preliminary findings. Ann Emerg Med 1990;19(10):1148–51.CrossRefGoogle ScholarPubMed
Lin, JJ, Hsia, SH, Wang, HS, Chiang, MC, Lin, KL. Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation. Resuscitation 2015;89: 182–7.CrossRefGoogle ScholarPubMed
Baghshomali, S, Reynolds, P, Sarwal, A. Transcranial doppler to assess cerebral blood flow in patients on extra corporeal membrane oxygenation (P4.236). Neurology 2014;82(10 Supplement):236.CrossRefGoogle Scholar
Bouzat, P, Oddo, M, Payen, JF. Transcranial Doppler after traumatic brain injury: is there a role? Curr Opin Crit Care 2014;20(2):153–160.CrossRefGoogle ScholarPubMed
Czosnyka, M, Smielewski, P, Kirkpatrick, P, Menon, DK, Pickard, JD. Monitoring of cerebral autoregulation in head-injured patients. Stroke 1996;27(10):1829–34.CrossRefGoogle ScholarPubMed
Coles, JP. Regional ischemia after head injury. Curr Opin Crit Care 2004;10(2):120–5.CrossRefGoogle ScholarPubMed
Rosner, MJ, Daughton, S. Cerebral perfusion pressure management in head injury. J Trauma 1990;30(8):933–40.CrossRefGoogle ScholarPubMed
Jaggi, JL, Obrist, WD, Gennarelli, TA, Langfitt, TW. Relationship of early cerebral blood flow and metabolism to outcome in acute head injury. J Neurosurg 1990;72(2):176–82.CrossRefGoogle ScholarPubMed
van Santbrink, H, Schouten, JW, Steyerberg, EW, Avezaat, CJ, Maas, AI. Serial transcranial Doppler measurements in traumatic brain injury with special focus on the early posttraumatic period. Acta Neurochir (Wien) 2002;144(11):1141–9.CrossRefGoogle ScholarPubMed
Zurynski, YA, Dorsch, NW, Fearnside, MR. Incidence and effects of increased cerebral blood flow velocity after severe head injury: a transcranial Doppler ultrasound study II. Effect of vasospasm and hyperemia on outcome. J Neurol Sci 1995;134(1-2):41–6.Google ScholarPubMed
Jaffres, P, Brun, J, Declety, P, et al. Transcranial Doppler to detect on admission patients at risk for neurological deterioration following mild and moderate brain trauma. Intensive Care Med 2005;31(6):785–90.CrossRefGoogle ScholarPubMed
Camerlingo, M L Casto, B Censori, MC, et al. Prognostic use of ultrasonography in acute non-hemorrhagic carotid stroke. Ital J Neurol Sci 1996;17(3):215–18.CrossRefGoogle ScholarPubMed
D’Andrea, A, Conte, M, Scarafile, R, et al. Transcranial Doppler ultrasound: physical principles and principal applications in neurocritical care unit. J Cardiovasc Echogr 2016;26(2):28–41.CrossRefGoogle ScholarPubMed
Stolz, E, Cioli, F, Allendoerfer, J, et al. Can early neurosonology predict outcome in acute stroke?: a metaanalysis of prognostic clinical effect sizes related to the vascular status. Stroke 2008;39(12):3255–61.CrossRefGoogle Scholar
Alexandrov, AV, Grotta, JC. Arterial reocclusion in stroke patients treated with intravenous tissue plasminogen activator. Neurology 2002;59(6):862–7.CrossRefGoogle ScholarPubMed
Powers, WJ, Rabinstein, AA, Ackerson, T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2019;50(12):e344–e418.CrossRefGoogle Scholar
Nogueira, RG, Jadhav, AP, Haussen, DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018;378(1):11–21.CrossRefGoogle ScholarPubMed
Goyal, M, Demchuk, AM, Menon, BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015;372(11):1019–30.CrossRefGoogle ScholarPubMed
Hong, L, Cheng, X, Lin, L, et al. The blood pressure paradox in acute ischemic stroke. Ann Neurol 2019;85(3):331–9.CrossRefGoogle ScholarPubMed
Gomez, J, Wolfe, S, Sarwal, A. Sonographic demonstration of a perfusion-dependent stroke with negative MRI and a flow-limiting stenosis. Neurocrit Care 2019;32(3):883–8.Google Scholar
Silvestrini, M, Troisi, E, Matteis, M, Razzano, C, Caltagirone, C. Correlations of flow velocity changes during mental activity and recovery from aphasia in ischemic stroke. Neurology 1998;50(1):191–5.CrossRefGoogle ScholarPubMed
Carney, N, Totten, AM, O’Reilly, C, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery 2017;80(1):6–15.CrossRefGoogle ScholarPubMed
Kumar, G, Alexandrov, AV. Vasospasm surveillance with transcranial doppler sonography in subarachnoid hemorrhage. J Ultrasound Med 2015;34(8):1345–50.CrossRefGoogle ScholarPubMed