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Association between cerebral oxygenation and usual parameters of cerebral perfusion in critically ill patients with acute brain injury.
J Cereb Blood Flow Metab
January 2025
AP-HP, Hôpital Lariboisière, Department of Anaesthesia and Critical Care, Paris, France.
In patients with acute brain injury (ABI), optimizing cerebral perfusion parameters relies on multimodal monitoring. This include data from systemic monitoring-mean arterial pressure (MAP), arterial carbon dioxide tension (PaCO), arterial oxygen saturation (SaO), hemoglobin levels (Hb), and temperature-as well as neurological monitoring-intracranial pressure (ICP), cerebral perfusion pressure (CPP), and transcranial Doppler (TCD) velocities. We hypothesized that these parameters alone were not sufficient to assess the risk of cerebral ischemia.
View Article and Find Full Text PDFNorepinephrine titration in patients with sepsis-induced encephalopathy: cerebral pulsatility index compared to mean arterial pressure guided protocol: randomized controlled trial.
BMC Anesthesiol
January 2025
Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University Hospitals, Tanta, Gharbya, Egypt.
Background: Although surviving sepsis campaign (SSC) guidelines are the standard for sepsis and septic shock management, outcomes are still unfavourable. Given that perfusion pressure in sepsis is heterogeneous among patients and within the same patient; we evaluated the impact of individualized hemodynamic management via the transcranial Doppler (TCD) pulsatility index (PI) on mortality and outcomes among sepsis-induced encephalopathy (SIE) patients.
Methods: In this prospective, single-center randomized controlled study, 112 patients with SIE were randomly assigned.
Non-invasive 4D transcranial functional ultrasound and ultrasound localization microscopy for multimodal imaging of neurovascular response.
Sci Rep
December 2024
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, 27599, USA.
A long-standing goal of neuroimaging is the non-invasive volumetric assessment of whole brain function and structure at high spatial and temporal resolutions. Functional ultrasound (fUS) and ultrasound localization microscopy (ULM) are rapidly emerging techniques that promise to bring advanced brain imaging and therapy to the clinic with the safety and low-cost advantages associated with ultrasound. fUS has been used to study cerebral hemodynamics at high temporal resolutions while ULM has been used to study cerebral microvascular structure at high spatial resolutions.
View Article and Find Full Text PDFA multimodal neuroimaging study of cerebrovascular regulation: Protocols and insights of combining electroencephalography, functional near-infrared spectroscopy, transcranial Doppler ultrasound, and physiological parameters.
J Neural Eng
January 2025
University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, CANADA.
The current paper describes the creation of a simultaneous trimodal neuroimaging protocol. The authors detail their methodological design for a subsequent large-scale study, demonstrate the ability to obtain the expected physiologically induced responses across cerebrovascular domains, and describe the pitfalls experienced when developing this approach. Approach: Electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and transcranial Doppler ultrasound (TCD) were combined to provide an assessment of neuronal activity, microvascular oxygenation, and upstream artery velocity, respectively.
View Article and Find Full Text PDFOptimal Cerebral Protection Confirmed by Transcranial Doppler During Transcarotid Artery Revascularization.
Methodist Debakey Cardiovasc J
December 2024
Houston Methodist Hospital, Houston, Texas, US.
Transcarotid artery revascularization (TCAR) is a novel method to treat severe stenosis of the carotid artery with minimal embolization. During TCAR, flow reversal system redirects blood from the internal, external, and common carotid arteries into the femoral vein through a filter system to prevent debris and microparticles from entering the cerebral circulation. Transcranial Doppler (TCD) monitoring allows real-time detection of blood flow in the cerebral arteries during the operation and informs the surgeon of flow changes or possible emboli.
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