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Non-invasive estimation of cerebral perfusion pressure using transcranial Doppler ultrasonography in children with severe traumatic brain injury
Objective To identify if cerebral perfusion pressure (CPP) can be non-invasively estimated by either of two methods calculated using transcranial Doppler ultrasound (TCD) parameters. Design Retrospective review of previously prospectively gathered data. Setting Pediatric intensive care unit in a ter...
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Published in: | Child's nervous system 2020-09, Vol.36 (9), p.2063-2071 |
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Main Authors: | , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Objective
To identify if cerebral perfusion pressure (CPP) can be non-invasively estimated by either of two methods calculated using transcranial Doppler ultrasound (TCD) parameters.
Design
Retrospective review of previously prospectively gathered data.
Setting
Pediatric intensive care unit in a tertiary care referral hospital.
Patients
Twenty-three children with severe traumatic brain injury (TBI) and invasive intracranial pressure (ICP) monitoring in place.
Interventions
TCD evaluation of the middle cerebral arteries was performed daily. CPP at the time of the TCD examination was recorded. For method 1, estimated cerebral perfusion pressure (CPPe) was calculated as: CPPe = MAP × (diastolic flow (Vd)/mean flow (Vm)) + 14. For method 2, critical closing pressure (CrCP) was identified as the intercept point on the
x
-axis of the linear regression line of blood pressure and flow velocity parameters. CrCP/CPPe was then calculated as MAP-CrCP.
Measurements and main results
One hundred eight paired measurements were available. Using patient averaged data, correlation between CPP and CPPe was significant (
r
= 0.78,
p
= |
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ISSN: | 0256-7040 1433-0350 |
DOI: | 10.1007/s00381-020-04524-7 |