Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review.
PURPOSE
Transcranial Doppler (TCD) has been used for more than 30 years in clinical practice. Although adult intensive care is relatively well covered, pediatric cases are still underrepresented. We intend to review a series of pediatric cases where TCD was determinant in clinical decisions and a literature review on this topic.


METHODS
We describe cases with different pathologies where TCD had an important role in clinical management of the patients. We discuss TCD utility and potential role both in the emergency department and the intensive care unit.


RESULTS
Five patients with different neurologic insults are presented. TCD was useful in the identification of intracranial hypertension in traumatic brain injury, hydrocephalus and central nervous system infection; identification of decreased cerebral perfusion pressure in hypovolemic shock and the diagnosis of impending cerebral circulatory arrest in a child with meningococcal septicemia. We discuss how TCD can be used in emergency and intensive care settings, reviewing relevant literature and our own experience.


CONCLUSIONS
Non-invasive testing using TCD can aid clinical decisions. More widespread use of this technique will allow for better care of children with neurologic insults.
['Abecasis|Francisco|F|0000-0002-1883-050X', 'Oliveira|Vitor|V|', 'Robba|Chiara|C|', 'Czosnyka|Marek|M|']
D000293:Adolescent D000070642:Brain Injuries, Traumatic D002648:Child D004636:Emergency Service, Hospital D005260:Female D006801:Humans D006849:Hydrocephalus D007223:Infant D015278:Intensive Care Units, Pediatric D008297:Male D008585:Meningitis, Meningococcal D008586:Meningitis, Pneumococcal D017585:Ultrasonography, Doppler, Transcranial
Transcranial Doppler Intracranial hypertension Traumatic brain injury Neuromonitoring