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Transkaranielle Messung Intraoperativ Extrakranielle Messung Monitoring Funktionstest Dopplersonographie HAL Image Map Transcranial Operativ Excranial Monitoring Function Test Doppler Sonography HAL Image Map

Reanimation

Further information:

Trends Dementia Sonothrombolysis ICP Brain pressure Parkinson


Hintergrund

The brain is the human organ, which is most sensitive to hypoxia. Hence, the brain perfusion is the major success parameter during cardio-pulmonary resuscitation (CPR). An assessment of effectiveness is usually only possible by evaluation of clinical signs (e.g. pupil width) or plethysmographic derived peripheral oxygen saturation (Cave: good specificity, worse sensitivity). TCD offers a method to derive intracerebral blood flow velocities as a parameter of cerebral perfusion with a high temporal resolution (beat-to-beat) (Blumenstein et al., 2010).

In the last years, an interesting scientific focus was on evaluation of blood flow patterns following successful CPR (ROSC = return of spontaneous circulation) to assess patient´s clinical outcome. Alvarez-Fernandez postulated in 2011 that TCD examinations might help to identify irreversibly neurologically impaired patients after ROSC to reduce unreasonable and ineffective treatment, which may have harmful side effects. Previously, also Wessels et al. (2006) could demonstrate a significant association between TCD parameters and prognosis following ROSC.

Ausblick:


Although some studies assume that impaired cerebral haemodynamics after ROSC draw conclusion on clinical outcome, it remains to be determined which parameter (possibly: max. peak systolic flow after 4 or 72 h??) can provide useful information since randomized trials are not available so far.
This needs to be discussed controversially, especially regarding ethical aspects:
Should a doctor refuse a patient, who is supposed to have high likelihood of bad clinical outcome, the best available treatment??

It is noncontroversial that a real-time TCD monitoring is a valuable parameter of cerebral blood flow. Because of the device size and insufficient device mobility, nevertheless, it is difficult to put it into practice.
Downloads
Literature: Sonothrombolysis
Open PDF (147 KB)


Literature: Dementia
Open PDF (78 KB)


Literature: ICP Brain pressure
Open PDF (115 KB)


Literature: Parkinson
Open PDF (82 KB)


Literature: Reanimation
Open PDF (78 KB)

Atlas of Doppler Sonography

Literaturresearch

download pdfAnästhesie (EN) PDF | 144 KB
download pdfAutoregulation (EN) PDF | 163 KB
download pdfDemenz (EN) PDF | 178 KB
download pdfEmbolie Differenzierung (EN) PDF | 113 KB
download pdfEmbolie Gefäßchirurgie (EN) PDF | 232 KB
download pdfEmbolie Schlaganfallrisiko (EN) PDF | 182 KB
download pdfFunktionelle TCD (EN) PDF | 198 KB
download pdfHirndruck (EN) PDF | 141 KB
download pdfHirntod (EN) PDF | 233 KB
download pdfICU (EN) PDF | 162 KB
download pdfMikrodoppler (EN) PDF | 124 KB
download pdfParkinson (EN) PDF | 85 KB
download pdfReanimation (EN) PDF | 94 KB
download pdfRechts-Links Shunt (EN) PDF | 201 KB
download pdfSichelzellenanämie (EN) PDF | 152 KB
download pdfSonothrombolyse (EN) PDF | 175 KB
download pdfSchlaganfall (EN) PDF | 192 KB
download pdfVasospasmus (EN) PDF | 140 KB
download pdfAnaesthesiology (PDF | 144 KB)
download pdfAutoregulation (PDF | 163 KB)
download pdfDementia (PDF | 178 KB)
download pdfEmboli differentiation (PDF | 113 KB)
download pdfEmboli vascular surgery (PDF | 232 KB)
download pdfEmboli stroke risk (PDF | 182 KB)
download pdfFunctional TCD (PDF | 198 KB)
download pdfBrain pressure (PDF | 141 KB)
download pdfBrain death (PDF | 233 KB)
download pdfICU (PDF | 162 KB)
download pdfMicrodoppler (PDF | 124 KB)
download pdfParkinson (PDF | 85 KB)
download pdfReanimation (PDF | 94 KB)
download pdfRight-Left-Shunt Detection (PDF | 201 KB)
download pdfSickle cell anemia (PDF | 152 KB)
download pdfSonothrombolysis (PDF | 175 KB)
download pdfStroke (PDF | 192 KB)
download pdfVasospasm (PDF | 140 KB)

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