Transcranial Doppler and Color‐Coded Doppler Use for Brain Death Determination in Adult Patients: A Pictorial Essay

Author:

Deana Cristian1ORCID,Biasucci Daniele G.234ORCID,Aspide Raffaele5,Brasil Sergio6ORCID,Vergano Marco7,Leonardis Francesca38,Rica Ermal1,Cammarota Gianmaria910,Dauri Mario23ORCID,Vetrugno Giuseppe411,Longhini Federico12,Maggiore Salvatore Maurizio1314,Rasulo Frank15,Vetrugno Luigi1416ORCID

Affiliation:

1. Department of Anesthesia and Intensive Care Health Integrated Agency of Friuli Centrale Udine Italy

2. Department of Clinical Science and Translational Medicine “Tor Vergata” University Rome Italy

3. Emergency Department “Tor Vergata” University Hospital Rome Italy

4. Catholic University of the Sacred Heart (UCSC) Rome Italy

5. Anesthesia and Neurointensive Care Unit Istituto delle Scienze Neurologiche IRCCS Bologna Italy

6. Neurosurgical Division, Department of Neurology University of São Paulo School of Medicine São Paulo Brazil

7. Department of Anesthesia and Intensive Care San Giovanni Bosco Hospital Torino Italy

8. Department of Surgical Science “Tor Vergata” University Rome Italy

9. Department of Anesthesiology and Intensive Care Azienda Ospedaliero‐Universitaria “Maggiore della Carità” Novara Italy

10. Department of Translational Medicine Università degli Studi del Piemonte Orientale Novara Italy

11. Risk Management Fondazione Policlinico Universitario “A. Gemelli” IRCCS Rome Italy

12. Department of Medical and Surgical Sciences University Hospital Mater Domini, Magna Graecia University Catanzaro Italy

13. Department of Innovative Technologies in Medicine & Dentistry, Section of Anesthesia and Intensive Care “G. D'Annunzio” University, “SS. Annunziata” Hospital Chieti Italy

14. Department of Anesthesiology Critical Care Medicine and Emergency, “SS. Annunziata” Hospital Chieti Italy

15. Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia Brescia Italy

16. Department of Medical, Oral and Biotechnological Science “G. d'Annunzio” Chieti‐Pescara University Chieti Italy

Abstract

Transcranial Doppler (TCD) is a repeatable, at‐the‐bedside, helpful tool for confirming cerebral circulatory arrest (CCA). Despite its variable accuracy, TCD is increasingly used during brain death determination, and it is considered among the optional ancillary tests in several countries. Among its limitations, the need for skilled operators with appropriate knowledge of typical CCA patterns and the lack of adequate acoustic bone windows for intracranial arteries assessment are critical. The purpose of this review is to describe how to evaluate cerebral circulatory arrest in the intensive care unit with TCD and transcranial duplex color‐coded doppler (TCCD).

Publisher

Wiley

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