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Minerva Anestesiologica 2020 March;86(3):327-40

DOI: 10.23736/S0375-9393.19.13852-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

How to use cerebral ultrasound in the ICU

Rita BERTUETTI ¹, Paolo GRITTI ², Paolo PELOSI ³, Chiara ROBBA ⁴ ✉

¹ Department of Anesthesia, Intensive Care and Emergency Medicine, Spedali Civili University Hospital, Brescia, Italy; ² Department of Anesthesia and Critical Care Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy; ³ Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy; ⁴ Department of Surgical Sciences and Integrated Diagnostics, San Martino University Hospital IRCCS, University of Genoa, Genoa, Italy

Cerebral ultrasound is a developing point of care tool for intensivists and emergency physicians, with an important role in the diagnosis of acute intracranial pathology, such as the assessment of cerebrovascular diseases and in the noninvasive intracranial pressure measurement both in the acute clinical settings and in intensive care unit (ICU). The traditional application of transcranial doppler (TCD) by assessing blood flow velocities in the main cerebral arteries, allows the evaluation and follow up of cerebral vasospasm, cerebral perfusion pressure, cerebral autoregulation and intracranial hypertension. The use of TCD, traditionally limited to the neurosonology laboratories settings, has expanded over the last years following the introduction of B-mode ultrasound and color Doppler, the transcranial color-coded duplex ultrasonography (TCCS), opening a new window to the assessment of cerebral anatomy not only in the neurocritical patients, but also in general ICU and emergency room patients. Here we report a brief review with the intent to up-to-date and describe the main applications and use of TCD/TCCS in the setting of Neurointensive Care.

KEY WORDS: Brain injuries; Ultrasonography, Doppler, transcranial; Intensive Care Units