Ultrasound-guided cerebral resuscitation in patients with severe traumatic brain Injury.
Francisco Marcelo TamagnoneIssac CheongEzequiel LunaIgnacio PreviglianoVictoria Otero CastroPublished in: Journal of clinical monitoring and computing (2022)
Traumatic brain injury (TBI) is a worldwide public health concern given its significant morbidity and mortality, years of potential life lost, reduced quality of life and elevated healthcare costs. The primary injury occurs at the moment of impact, but secondary injuries might develop as a result of brain hemodynamic abnormalities, hypoxia, and hypotension. The cerebral edema and hemorrhage of the injured tissues causes a decrease in cerebral perfusion pressure (CPP), which leads to higher risk of cerebral ischemia, herniation and death. In this setting, our role as physicians is to minimize damage by the optimization of the CPP and therefore to reduce mortality and improve neurological outcomes. Performing a transcranial doppler ultrasound (TCD) allows to estimate cerebral blood flow velocities and identify states of low flow and high resistance. We propose to include TCD as an initial assessment and further monitoring tool for resuscitation guidance in patients with severe TBI. We present an Ultrasound-Guided Cardio-cerebral Resuscitation (UGCeR) protocol in Patients with Severe TBI.
Keyphrases
- cerebral ischemia
- traumatic brain injury
- severe traumatic brain injury
- subarachnoid hemorrhage
- cerebral blood flow
- ultrasound guided
- cardiac arrest
- brain injury
- public health
- blood brain barrier
- healthcare
- cardiopulmonary resuscitation
- fine needle aspiration
- septic shock
- magnetic resonance imaging
- primary care
- cardiovascular disease
- gene expression
- randomized controlled trial
- early onset
- endothelial cells
- multiple sclerosis
- computed tomography
- risk factors
- magnetic resonance
- oxidative stress
- cardiovascular events
- drug induced
- blood flow
- social media