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Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study
BACKGROUND: The aim of this study is to evaluate the feasibility and efficacy of Transcranial Doppler (TCD) in assessing cerebral perfusion changes in septic patients. METHODS: Using TCD, we measured the mean velocity in the middle cerebral artery (VmMCA, cm/sec) and calculated the pulsatility index...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765692/ https://www.ncbi.nlm.nih.gov/pubmed/23965228 http://dx.doi.org/10.1186/2110-5820-3-28 |
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author | Pierrakos, Charalampos Antoine, Aurélie Velissaris, Dimitrios Michaux, Isabelle Bulpa, Pierre Evrard, Patrick Ossemann, Michel Dive, Alain |
author_facet | Pierrakos, Charalampos Antoine, Aurélie Velissaris, Dimitrios Michaux, Isabelle Bulpa, Pierre Evrard, Patrick Ossemann, Michel Dive, Alain |
author_sort | Pierrakos, Charalampos |
collection | PubMed |
description | BACKGROUND: The aim of this study is to evaluate the feasibility and efficacy of Transcranial Doppler (TCD) in assessing cerebral perfusion changes in septic patients. METHODS: Using TCD, we measured the mean velocity in the middle cerebral artery (VmMCA, cm/sec) and calculated the pulsatility index (PI), resistance index (RI) and cerebral blood flow index (CBFi = 10*MAP/1.47(PI)) on the first day of patients’ admission or on the first day of sepsis development; measurements were repeated on the second day. Sepsis was defined according to standard criteria. RESULTS: Forty-one patients without any known neurologic deficit treated in our 24-bed Critical Care Unit were assessed (Sepsis Group = 20, Control Group = 21). Examination was feasible in 91% of septic and 85% of non-septic patients (p = 0.89). No difference was found between the two groups in mean age, mean arterial pressure (MAP) or APACHE II score. The pCO(2) values were higher in septic patients (46 ± 12 vs. 39 ± 4 mmHg p < 0.01). No statistically significant higher values of VmMCA were found in septic patients (110 ± 34 cm/sec vs. 99 ± 28 cm/sec p = 0.17). Higher values of PI and RI were found in septic patients (1.15 ± 0.25 vs. 0.98 ± 0.16 p < 0.01, 0.64 ± 0.08 vs. 0.59 ± 0.06 p < 0.01, respectively). No statistically significant lower values of CBFi were found in septic patients (497 ± 116 vs. 548 ± 110 p = 0.06). CONCLUSIONS: Our results suggest cerebral vasoconstriction in septic compared to non-septic patients. TCD is an efficient and feasible exam to evaluate changes in cerebral perfusion during sepsis. |
format | Online Article Text |
id | pubmed-3765692 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer |
record_format | MEDLINE/PubMed |
spelling | pubmed-37656922013-09-10 Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study Pierrakos, Charalampos Antoine, Aurélie Velissaris, Dimitrios Michaux, Isabelle Bulpa, Pierre Evrard, Patrick Ossemann, Michel Dive, Alain Ann Intensive Care Research BACKGROUND: The aim of this study is to evaluate the feasibility and efficacy of Transcranial Doppler (TCD) in assessing cerebral perfusion changes in septic patients. METHODS: Using TCD, we measured the mean velocity in the middle cerebral artery (VmMCA, cm/sec) and calculated the pulsatility index (PI), resistance index (RI) and cerebral blood flow index (CBFi = 10*MAP/1.47(PI)) on the first day of patients’ admission or on the first day of sepsis development; measurements were repeated on the second day. Sepsis was defined according to standard criteria. RESULTS: Forty-one patients without any known neurologic deficit treated in our 24-bed Critical Care Unit were assessed (Sepsis Group = 20, Control Group = 21). Examination was feasible in 91% of septic and 85% of non-septic patients (p = 0.89). No difference was found between the two groups in mean age, mean arterial pressure (MAP) or APACHE II score. The pCO(2) values were higher in septic patients (46 ± 12 vs. 39 ± 4 mmHg p < 0.01). No statistically significant higher values of VmMCA were found in septic patients (110 ± 34 cm/sec vs. 99 ± 28 cm/sec p = 0.17). Higher values of PI and RI were found in septic patients (1.15 ± 0.25 vs. 0.98 ± 0.16 p < 0.01, 0.64 ± 0.08 vs. 0.59 ± 0.06 p < 0.01, respectively). No statistically significant lower values of CBFi were found in septic patients (497 ± 116 vs. 548 ± 110 p = 0.06). CONCLUSIONS: Our results suggest cerebral vasoconstriction in septic compared to non-septic patients. TCD is an efficient and feasible exam to evaluate changes in cerebral perfusion during sepsis. Springer 2013-08-22 /pmc/articles/PMC3765692/ /pubmed/23965228 http://dx.doi.org/10.1186/2110-5820-3-28 Text en Copyright ©2013 Pierrakos et al.; licensee Springer. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Pierrakos, Charalampos Antoine, Aurélie Velissaris, Dimitrios Michaux, Isabelle Bulpa, Pierre Evrard, Patrick Ossemann, Michel Dive, Alain Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title | Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title_full | Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title_fullStr | Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title_full_unstemmed | Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title_short | Transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
title_sort | transcranial doppler assessment of cerebral perfusion in critically ill septic patients: a pilot study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765692/ https://www.ncbi.nlm.nih.gov/pubmed/23965228 http://dx.doi.org/10.1186/2110-5820-3-28 |
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