Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring.

Domenico Iacopino, Antonino Conti, Vincenzo Fodale, Letterio B. Santamaria, Alfredo Conti, Olivia Penna, Micalizzi, Iacopino

Risultato della ricerca: Article

77 Citazioni (Scopus)

Abstract

INTRODUCTION: Transcranial Doppler (TCD) can detect the cerebral circulation arrest (CCA) in brain death. TCD is highly specific, but less sensitive because of false-negatives accounting for up to 10%. The aim of the study was to explore the diagnostic accuracy of TCD and to determine whether it can be augmented by strategies such as the insonation of the extracranial internal carotid artery (ICA) and sequential examinations. METHODS: Data of 184 patients, who met clinical criteria of brain death, observed from 1998 through 2006, were retrospectively reviewed. The study of cerebral arteries was performed through the transtemporal approach, suboccipital insonation of the vertebro-basilar system, transorbital insonation of the ICA and ophthalmic artery, and transcervical insonation of the extracranial ICA. Repeated exams were performed in cases of persistent diastolic flow. RESULTS: The specificity of the testing was 100%, no false-positive cases were recorded. The sensitivity of conventional TCD examination was 82.1%. The insonation of the extracranial ICA increased sensitivity to 88% allowing the detection of CCA in those patients lacking temporal windows; serial examinations further increased sensitivity to 95.6%. CONCLUSIONS: The addition of insonation of the cervical ICA and of the siphon increased sensitivity of TCD. Nevertheless, a CCA flow patterns may appear later on those segments. Serial examinations, may be needed in those cases.
Lingua originaleEnglish
pagine (da-a)333-339
Numero di pagine7
RivistaBritish Journal of Anaesthesia
Volume97
Stato di pubblicazionePublished - 2006

Fingerprint

Internal Carotid Artery
Propofol
Cerebrovascular Circulation
Anesthesia
Hemodynamics
Brain Death
Ophthalmic Artery
Cerebral Arteries
remifentanil
sevoflurane

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cita questo

Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring. / Iacopino, Domenico; Conti, Antonino; Fodale, Vincenzo; Santamaria, Letterio B.; Conti, Alfredo; Penna, Olivia; Micalizzi; Iacopino.

In: British Journal of Anaesthesia, Vol. 97, 2006, pag. 333-339.

Risultato della ricerca: Article

@article{4c39db2e386648b08ca04462680ad5c9,
title = "Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring.",
abstract = "INTRODUCTION: Transcranial Doppler (TCD) can detect the cerebral circulation arrest (CCA) in brain death. TCD is highly specific, but less sensitive because of false-negatives accounting for up to 10{\%}. The aim of the study was to explore the diagnostic accuracy of TCD and to determine whether it can be augmented by strategies such as the insonation of the extracranial internal carotid artery (ICA) and sequential examinations. METHODS: Data of 184 patients, who met clinical criteria of brain death, observed from 1998 through 2006, were retrospectively reviewed. The study of cerebral arteries was performed through the transtemporal approach, suboccipital insonation of the vertebro-basilar system, transorbital insonation of the ICA and ophthalmic artery, and transcervical insonation of the extracranial ICA. Repeated exams were performed in cases of persistent diastolic flow. RESULTS: The specificity of the testing was 100{\%}, no false-positive cases were recorded. The sensitivity of conventional TCD examination was 82.1{\%}. The insonation of the extracranial ICA increased sensitivity to 88{\%} allowing the detection of CCA in those patients lacking temporal windows; serial examinations further increased sensitivity to 95.6{\%}. CONCLUSIONS: The addition of insonation of the cervical ICA and of the siphon increased sensitivity of TCD. Nevertheless, a CCA flow patterns may appear later on those segments. Serial examinations, may be needed in those cases.",
author = "Domenico Iacopino and Antonino Conti and Vincenzo Fodale and Santamaria, {Letterio B.} and Alfredo Conti and Olivia Penna and Micalizzi and Iacopino",
year = "2006",
language = "English",
volume = "97",
pages = "333--339",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",

}

TY - JOUR

T1 - Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring.

AU - Iacopino, Domenico

AU - Conti, Antonino

AU - Fodale, Vincenzo

AU - Santamaria, Letterio B.

AU - Conti, Alfredo

AU - Penna, Olivia

AU - Micalizzi, null

AU - Iacopino, null

PY - 2006

Y1 - 2006

N2 - INTRODUCTION: Transcranial Doppler (TCD) can detect the cerebral circulation arrest (CCA) in brain death. TCD is highly specific, but less sensitive because of false-negatives accounting for up to 10%. The aim of the study was to explore the diagnostic accuracy of TCD and to determine whether it can be augmented by strategies such as the insonation of the extracranial internal carotid artery (ICA) and sequential examinations. METHODS: Data of 184 patients, who met clinical criteria of brain death, observed from 1998 through 2006, were retrospectively reviewed. The study of cerebral arteries was performed through the transtemporal approach, suboccipital insonation of the vertebro-basilar system, transorbital insonation of the ICA and ophthalmic artery, and transcervical insonation of the extracranial ICA. Repeated exams were performed in cases of persistent diastolic flow. RESULTS: The specificity of the testing was 100%, no false-positive cases were recorded. The sensitivity of conventional TCD examination was 82.1%. The insonation of the extracranial ICA increased sensitivity to 88% allowing the detection of CCA in those patients lacking temporal windows; serial examinations further increased sensitivity to 95.6%. CONCLUSIONS: The addition of insonation of the cervical ICA and of the siphon increased sensitivity of TCD. Nevertheless, a CCA flow patterns may appear later on those segments. Serial examinations, may be needed in those cases.

AB - INTRODUCTION: Transcranial Doppler (TCD) can detect the cerebral circulation arrest (CCA) in brain death. TCD is highly specific, but less sensitive because of false-negatives accounting for up to 10%. The aim of the study was to explore the diagnostic accuracy of TCD and to determine whether it can be augmented by strategies such as the insonation of the extracranial internal carotid artery (ICA) and sequential examinations. METHODS: Data of 184 patients, who met clinical criteria of brain death, observed from 1998 through 2006, were retrospectively reviewed. The study of cerebral arteries was performed through the transtemporal approach, suboccipital insonation of the vertebro-basilar system, transorbital insonation of the ICA and ophthalmic artery, and transcervical insonation of the extracranial ICA. Repeated exams were performed in cases of persistent diastolic flow. RESULTS: The specificity of the testing was 100%, no false-positive cases were recorded. The sensitivity of conventional TCD examination was 82.1%. The insonation of the extracranial ICA increased sensitivity to 88% allowing the detection of CCA in those patients lacking temporal windows; serial examinations further increased sensitivity to 95.6%. CONCLUSIONS: The addition of insonation of the cervical ICA and of the siphon increased sensitivity of TCD. Nevertheless, a CCA flow patterns may appear later on those segments. Serial examinations, may be needed in those cases.

UR - http://hdl.handle.net/10447/3063

M3 - Article

VL - 97

SP - 333

EP - 339

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

ER -