6533b86cfe1ef96bd12c8c4c

RESEARCH PRODUCT

Transcranial doppler and near infrared spectroscopy in the perioperative period

Klaus Ulrich KleinPatrick SchrammStephanie Kampf

subject

Brain DeathSpectroscopy Near-InfraredUltrasonography Doppler Transcranialbusiness.industryOxygen metabolismBrainBlood flowPerioperativeNeurosurgical ProceduresCerebrovascular CirculationSilent ischemiaBrain IschemiaTranscranial DopplerOxygenAnesthesiology and Pain MedicineCerebrovascular CirculationAnesthesiaHumansMedicineCardiac Surgical ProceduresUltrasonographyPerioperative PeriodbusinessVascular Surgical Procedures

description

Maintenance of adequate blood flow and oxygen to the brain is one of the principal endpoints of all surgery and anesthesia. During operations in general anesthesia, however, the brain is at particular risk for silent ischemia. Despite this risk, the brain still remains one of the last monitored organs in clincial anesthesiology.Transcranial Doppler (TCD) sonography and near-infrared spectroscopy (NIRS) experience a revival as these noninvasive technologies help to detect silent cerebral ischemia. TCD allows for quantification of blood flow velocities in basal intracranial arteries. TCD-derived variables such as the pulsatility index might hint toward diminished cognitive reserve or raised intracranial pressure. NIRS allows for assessment of regional cerebral oxygenation. Monitoring should be performed during high-risk surgery for silent cerebral ischemia and special circumstances during critical care medicine. Both techniques allow for the assessment of cerebrovascular autoregulation and individualized management of cerebral hemodynamics.TCD and NIRS are noninvasive monitors that anesthesiologists apply to tailor cerebral oxygen delivery, aiming to safeguard brain function in the perioperative period.

yearjournalcountryeditionlanguage
2013-08-22Current Opinion in Anaesthesiology
https://doi.org/10.1097/01.aco.0000432517.70844.a6