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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5783_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Foreword
- •Acknowledgments
- •Contents
- •Contributors
- •1.2 How Is Critical Care Humanized?
- •References
- •2.1 Introduction
- •1.2.2 Communication
- •1.2.5 Post-ICU Syndrome
- •1.2.6 Humanized Infrastructure
- •1.2.7 End-of-Life Care
- •2.2 Which Patients Should Undergo ICP Monitoring?
- •2.5.2.3 CSF Drainage
- •2.5.2.4 Osmotherapy
- •2.5.2.5 Ventilation
- •2.5.2.6 CPP Augmentation
- •2.5.2.7 Metabolic Suppression
- •2.5.2.8 Pharmacologic Suppression
- •2.5.2.9 Temperature Modulation
- •2.5.2.10 Decompressive Craniectomy
- •2.7.1.1 Pressure Reactivity Index (PRx)
- •2.7.1.2 Multimodality Monitoring
- •2.8 Conclusion
- •Algorithm
- •References
- •3.1 Introduction
- •3.2 Intracerebral Hemorrhage (ICH)
- •3.3 ICH: Presenting Symptoms
- •3.5.1 Blood Hypertension
- •3.5.2 Other Risk Factors
- •3.6 ICH: Pathophysiology
- •3.7 ICH: Initial Management
- •3.7.1 Airway: Intubation
- •3.7.3 ICH: Imaging
- •3.7.4 ICH: Grading Scales
- •3.7.5 Fluid Management
- •3.7.6 Follow-Up Imaging
- •3.7.7 Blood Pressure Management
- •3.7.9 ICP Monitoring
- •3.7.10 Surgical Considerations
- •3.7.13 ICH: Venous Thromboembolism Prophylaxis
- •3.7.14 ICH: Seizure Management
- •3.8 ICH: Medical Complications
- •3.8.1 Glycemic Management
- •3.8.3 Disposition
- •3.9 Conclusion
- •Algorithm
- •Appendix: Direct Oral Anticoagulant Reversal
- •Reversal Strategies
- •References
- •4.1 Introduction
- •4.2.1 Hemodynamic Management
- •4.2.2 Hormonal Replacement Therapy
- •4.2.3 Respiratory Management
- •4.3 Cardiopulmonary Resuscitation (CPR)
- •4.4 Conclusion
- •Algorithm
- •References
- •5.1 Introduction
- •5.2.1 Vasoactive Agents
- •5.2.1.1 Vasodilators (Table 5.1)
- •Calcium Channel Blockers
- •Nimodipine
- •Nicardipine
- •Other Vasodilators
- •Magnesium
- •3-Hydroxy-3-Methyl-Glutaryl-CoA (HMG-CoA) Reductase Inhibitors (Statins)
- •Nitroprusside
- •Endothelin-1 Antagonists
- •Hydralazine
- •Phosphodiesterase Inhibitors
- •Papaverine
- •Norepinephrine
- •Epinephrine
- •Dopamine (DA)
- •Phenylephrine
- •Vasopressin
- •Neuromonitoring
- •5.2.2.1 Benzodiazepines
- •5.2.2.2 Barbiturates
- •5.2.2.3 Opioids
- •5.2.2.4 Anticonvulsant Medications
- •5.2.2.5 Other Sedatives/Anesthetics
- •5.2.3 Hemodynamic Agents
- •5.4 Conclusion
- •Algorithm
- •References
- •6.1 Introduction
- •6.2.3 Ultrasound Behaviour at Acoustic Boundaries
- •6.3 Pulse-Echo Principles (B-Mode Techniques)
- •6.4 Transducers
- •6.5 Artefacts
- •6.6 Doppler Principles
- •6.6.1 Pulsed Wave Doppler
- •6.6.2 Duplex Scanning
- •6.6.3 Colour Flow Imaging (CFI)
- •6.7.2 Flow Changes
- •6.7.3 Cerebrovascular Resistance
- •6.8 Transcranial Colour-Coded Duplex Sonography (TCCS)
- •6.9 Ultrasound Safety
- •6.10 Conclusion
- •References
- •7.1 Introduction
- •Mesencephalic Plane
- •7.2.1.2 Diencephalic Plane (Thalamic Plane)
- •6.6.4 Power Doppler Imaging (PDI)
- •6.7 Transcranial Doppler Ultrasound (TCD)
- •6.7.1 Velocity Measurement
- •7.2.1.3 Ventricular Plane (Cella Media)
- •7.2.1.4 Upper Pons Plane
- •7.2.1.5 Lower Pons Plane
- •7.2.2 Transforaminal Window
- •7.3.1.2 Anterior Circulation
- •Carotid System
- •Anterior Cerebral Artery
- •Anterior Communicating Antery
- •7.3.1.3 Posterior Circulation
- •Vertebrobasilar System
- •Posterior Communicating Artery
- •Posterior Cerebral Arteries
- •7.5 Cerebral Circulation: Anatomical Variations
- •7.5.1.1 Anterior Circulation
- •Most Common Variations [28]
- •7.5.1.2 Posterior Circulation
- •Most Common Variants [28]
- •7.6.1.1 Deep Middle Cerebral Vein (DMCV)
- •7.6.1.2 Basal Vein (of Rosenthal)
- •7.6.1.3 Great Cerebral Vein (of Galen)
- •7.6.2.1 Sphenoparietal Sinus
- •7.6.2.2 Superior Petrosal Sinus
- •7.6.2.3 Inferior Petrosal Sinus
- •7.6.2.4 Cavernous Sinus
- •7.6.2.5 Transverse Sinus
- •7.6.2.6 Straight Sinus
- •7.7 Conclusion
- •Algorithm
- •References
- •8.1 Introduction
- •8.2 Cerebral Blood Flow Measures
- •8.3 Transcranial Doppler (TCD/TCCS)
- •8.4.1 Cerebral Autoregulation (CA)
- •8.4.2 CO2 Vasoreactivity
- •8.6.2 TCD/TCCS: Use After Traumatic Brain Injury (TBI)
- •8.7 Conclusion
- •References
- •9.1 Introduction
- •9.3 TCD Hemodynamic Parameters: Variations by Sex
- •9.4 TCD Hemodynamic Parameters: Variations by Age
- •9.5 TCD Hemodynamic Parameters: Variations by Laterally
- •9.7 TCD Normal Values: Latin American Population Sample
- •9.8 TCD Hemodynamic Parameters: Altitude
- •9.10 Conclusion
- •References
- •10.1 Introduction
- •10.2 TCD/TCCS: Acoustic Windows
- •10.2.1.1 Technique
- •10.2.2.1 Technique
- •10.2.3.1 Technique
- •10.2.4.1 Technique
- •10.2.5.1 Technique
- •10.4.1 Decompressive Craniectomy
- •10.4.2 Patient’s Position
- •10.5 TCD/TCCS: Contrast-Enhanced
- •10.6 Conclusion
- •Algorithm
- •References
- •11.1 Introduction
- •11.2 Basic Methods
- •11.2.1 Flow Velocities
- •11.2.2 Pulsatility Index (PI)
- •11.3 Advanced Methods
- •11.3.2 TAU (Cerebrovascular Time Constant)
- •11.3.4 Autoregulation
- •11.4.1 Traumatic Brain Injury
- •11.4.2 Aneurysmal Subarachnoid Hemorrhage
- •11.4.3 Stroke
- •11.4.4 Other Clinical Scenarios
- •11.5 Conclusion
- •Algorithm
- •References
- •12.1 Introduction
- •12.2 TCD: Spectral Wave
- •12.4 TCD: Clinical Utility
- •12.6 TCD: Technique
- •12.6.2 Transtemporal Acoustic Window
- •12.6.2.1 Anterior Circulation
- •Middle Cerebral Artery (MCA)
- •12.6.2.2 Posterior Circulation
- •Posterior Cerebral Artery (PCA)
- •12.6.3 Submandibular Acoustic Window
- •12.6.3.1 Internal Carotid Artery (ICA—Extracranial Portion)
- •12.6.4 Transoccipital Acoustic Window
- •12.6.4.1 Posterior Circulation
- •12.6.5 Transorbital Acoustic Window
- •12.6.6.2 Pulsatility Index
- •12.7.1 High-Velocity Pattern
- •12.7.2 Low-Velocity Pattern
- •12.7.3 High Resistance Pattern
- •12.7.4 Cerebral Circulatory Arrest Pattern
- •12.8 TCD: Other Clinical Uses
- •12.8.1.1 Cerebral Vascular Reactivity
- •12.9 TCD: Limitations
- •12.10 Conclusion
- •Algorithm
- •References
- •13.1 Introduction
- •13.2 Acoustic Windows
- •13.3 2D-Guided TCD Monitoring
- •13.6 Conclusion
- •Algorithm
- •References
- •14.1 Introduction
- •14.2 TCCS: Anatomical Aspects
- •14.3.1 Anterior Circulation
- •14.3.1.1 Carotid System
- •14.3.2 Posterior Circulation
- •14.3.2.1 Vertebro-Basilar System
- •14.5 TCCS: Examiner Considerations
- •14.6 TCCS: Acoustic Windows
- •14.7 TCCS: Examination Protocol
- •14.7.1.1 Considerations
- •Doppler: (Convention)
- •14.7.2 Transtemporal Acoustic Window Examination (Coronal Planes)
- •14.7.3 Transoccipital (Transnuchal/Transforaminal) Acoustic Window Examination
- •14.7.4 Submandibular Acoustic Window Examination
- •14.7.5 Transorbital Acoustic Window Examination
- •14.7.6 Frontal Bone Window Examination
- •14.8 TCCS Protocol: Clinical Applications
- •14.9 TCCS Protocol: Hemodynamic Parameters
- •14.10 TCCS Protocol: Limitations
- •14.10.1 Limitations
- •14.10.1.1 Acoustic Windows
- •Transtemporal Acoustic Window
- •Suboccipital Acoustic Window
- •14.10.1.2 Middle-Line Shift Measurement
- •14.11 Conclusion
- •Algorithm
- •References
- •15.1 Introduction
- •15.2 Clinical Applications
- •15.2.1 Intracranial Stenosis
- •15.2.2 Cerebral Vasospasm
- •15.2.3 Cerebral Veins
- •15.3 Conclusion
- •References
- •16.1 Introduction
- •16.3.1 Autoregulation Index (ARI)
- •16.3.2 Mean Flow Velocity Index (Mx)
- •16.5 Conclusion
- •References
- •17.1 Introduction
- •17.2.1 Cerebrovascular Resistance (CVR)
- •17.2.2 Cerebral Autoregulation
- •17.2.4 Carbon Dioxide Reactivity
- •17.3.2 Collateral Flow
- •17.3.3 Elastic Reservoir (“Windkessel Effect”)
- •17.4 TCD: Waveform Interpretation
- •17.4.1 TCD Waveforms
- •17.5.1 Aneurysmal Subarachnoid Hemorrhage
- •17.5.2 Increased ICP
- •17.6 Conclusion
- •References
- •18.1 Introduction
- •18.3.1 Subarachnoid Hemorrhage (SAH)
- •18.3.1.1 Cerebral Autoregulation (CA)
- •18.3.1.2 Intraparenchymal Cerebral Oxygen Monitoring
- •18.3.1.3 Cerebral Blood Flow
- •18.3.1.4 Electrophysiology
- •Seizure Detection
- •18.3.1.5 Cerebral Metabolism
- •18.3.2 Intracerebral Hemorrhage (ICH)
- •18.3.2.1 Intraparenchymal Cerebral Oxygen Monitoring
- •18.3.2.3 Electrophysiology
- •18.3.3 Traumatic Brain Injury (TBI)
- •18.3.3.2 Cerebral Autoregulation
- •18.3.3.3 Intraparenchymal Cerebral Oxygen Monitoring
- •18.3.3.4 Cerebral Blood Flow
- •18.3.3.5 Electrophysiology
- •18.3.3.6 Cerebral Metabolism
- •18.3.4 Acute Ischemic Stroke (AIS)
- •18.3.4.1 Cerebral Blood Flow
- •18.3.4.2 Electrophysiology
- •18.3.5.1 Cerebral Blood Flow
- •18.4 Conclusion
- •References
- •19.1 Introduction
- •19.2 Cerebral Blood Haemodynamic Measurements
- •19.3 Cerebral Blood Flow (CBF): Physiology Principles
- •19.4 Vasoreactivity Determining: Methods
- •19.6 Technical Tips
- •19.7 Vasoreactivity: Clinical Importance
- •19.8 Conclusion
- •References
- •20.1 Introduction
- •20.5.4.1 Experimental Endotoxemia
- •20.6 Conclusion
- •Appendix
- •Methods
- •Group 1: Graphic Methods
- •“Beat-by-Beat Method”
- •Method Described by Aaslid
- •Group 2: Multiparameter or Impedance Methods [14]
- •References
- •21.1 Introduction
- •21.2.1 Brain Compliance
- •21.2.2 TCD/TCCS: Cerebral Hemodynamics
- •21.4 Pulsatility Index (PI): Intracranial Pressure (ICP)
- •21.5.1 Cardiovascular Factors
- •21.5.2 Cerebrovascular Factors
- •21.5.3 Cardiopulmonary Factors
- •21.5.4 Metabolism Factors
- •21.5.5 Vascular Factors
- •21.5.6 Other Factors
- •21.6 Conclusion
- •Algorithm
- •References
- •22.1 Introduction
- •22.2 Aneurysmal Subarachnoid Hemorrhage (aSAH)
- •22.3 Cerebral Vasospasm After aSAH
- •22.5.1 TCD/TCCS: Examination Protocol
- •22.5.1.1 Transtemporal Window
- •22.5.1.2 Orbital Window
- •22.5.1.3 Suboccipital/Transforaminal Window
- •22.5.1.4 Submandibular Window
- •22.7 Conclusion
- •Algorithm
- •References
- •23.1 Introduction
- •23.3.1 Premise
- •23.3.3 Limitations
- •23.4.1 Technical Requirements
- •23.4.3 Limitations
- •23.6 Future Directions
- •23.7 Conclusion
- •Algorithm
- •References
- •24.1 Introduction
- •24.2.1 Vasospasm
- •24.2.2 Vasospasm Diagnostic Criteria
- •24.3 TCD/TCCS: Cerebral Vasoreactivity
- •24.4 TCD/TCCS: Intraoperative Monitoring
- •24.7 Conclusion
- •References
- •25.1 Introduction
- •25.4 CAD: Diagnosis
- •25.6 Pupil: Ultrasound Examination
- •25.11 Conclusion
- •Algorithm
- •References
- •26.1 Introduction
- •26.2 Optimal Settings
- •26.2.1 Probe Types
- •26.2.2 Frequencies
- •26.2.3 Focus
- •26.2.4 Depth
- •26.2.5 Pulse Repetition Frequency (PRF)
- •26.2.6 Frame Rate
- •26.2.8 Freeze
- •26.2.9 Cine Loop
- •26.2.10 Smoothing (Interpolation), Interlacing, Correlation
- •26.2.11 Postprocessing
- •26.2.12 Resolution
- •26.2.13 Doppler-Technique
- •26.2.14 PW-Doppler (Pulsed-Wave Doppler)
- •26.2.15 Color Duplex
- •26.3 Indications
- •26.4.1.2 Morphological Differences
- •26.4.1.3 Flow Differences
- •26.4.1.4 Compression
- •26.5 B-Mode Examination
- •26.5.1 Dilation
- •26.5.2 Intima-Media Thickness (IMT)
- •26.5.3 Plaque Analysis
- •26.5.3.1 Location
- •26.5.3.3 Maximal Thickness
- •26.5.3.4 Surface
- •26.5.3.5 Echogenicity
- •26.5.4 B-Flow Imaging
- •26.6.1 Color Doppler Imaging (CDI)
- •26.6.2 Power Doppler Imaging (PDI)
- •26.7.1 Stenosis Measurement
- •26.7.1.1 Diameter Stenosis
- •26.7.1.2 Area Stenosis
- •26.7.1.3 Residual Luminal Diameter
- •26.7.2 Occlusion
- •26.7.3 Subtotal Stenosis: (>95% Stenosis)
- •26.7.4 Long Segment Stenosis
- •26.8 Doppler Spectrum
- •26.10 Contrast Enhanced Ultrasound (CEU)
- •26.11.1 Common Carotid Artery
- •26.11.2 Internal Carotid Artery
- •26.11.2.1 Stenosis
- •26.11.2.2 Dissection
- •26.11.2.3 Occlusion
- •26.11.2.4 Subtotal Occlusion: (95–99% Stenosis)
- •26.11.2.5 Multiple (Tandem) Stenosis
- •26.11.2.6 Long Segment Stenosis
- •26.11.3 External Carotid Artery (ECA)
- •26.11.3.1 Occlusion
- •26.13 Negative Report
- •26.14 Conclusion
- •Algorithm
- •References
- •27.1 Introduction
- •27.2 Anatomy: Vertebrobasilar System
- •27.3 Vertebrobasilar Circulation: Ultrasound Examination
- •27.4 TCD: Aneurysmal Subarachnoid Hemorrhage
- •27.4.1 Delayed Cerebral Ischemia
- •27.4.2 Vasospasm
- •27.5 TCD: Vertebrobasilar Dissection
- •27.6 TCD: Intracranial Stenosis
- •27.7 TCD: Microembolus Detection
- •27.9 Subclavian Steal Syndrome
- •27.10 TCD: Multimodal Monitoring
- •27.11 TCD: Traumatic Brain Injury
- •27.12 TCD: Brain Death Determination
- •27.13 Conclusion
- •References
- •28.1 Introduction
- •28.2 Cerebral Venous System: Anatomy
- •28.3 vTCCS: Ultrasound Investigation Technique
- •28.4 CVST: Venous Ultrasound Findings

Contents
20 Critical Closing Pressure in Acute Brain Injury: Usefulness of
Transcranial Doppler as Neuromonitoring . . . . . . . . . . . . . . . . . . . . 341
Corina Puppo, Leandro Moraes, and Bernardo Yelicich
21 Transcranial Doppler Ultrasound Pulsatility Index: Utility
and Clinical Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
Oscar M. Pinillos, Camilo N. Rodríguez, and Ryan Hakimi
22 Transcranial Doppler in Subarachnoid Hemorrhage: Usefulness
in the Diagnosis and Monitoring of Cerebral Vasospasm . . . . . . . . . 377
Fabienne Perren
23 Subarachnoid Hemorrhage (SAH) in the Neuro-ICU: Usefulness
of Transcranial Doppler (TCD/TCCS) for Delayed Cerebral
Ischemia (DCI) Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Frederick A. Zeiler and Jeanne Teitelbaum
24 Aneurysmal Subarachnoid Hemorrhage and Endovascular
Treatment: Usefulness of Transcranial Doppler (TCD/TCCS)
for Cerebral Hemodynamic Monitoring . . . . . . . . . . . . . . . . . . . . . . . 411
Laura Llull Estrany
25 Carotid Dissection in ICU: Usefulness of Bedside Ultrasound
Examination and Pupillary Early Approach . . . . . . . . . . . . . . . . . . . 421
Claudio Baracchini and Filippo Farina
xiii
26 Carotid Disease: Usefulness of the Ultrasound . . . . . . . . . . . . . . . . . 437
Gyula Pánczél, Vendel Kemény, László Oláh, and László Csiba
27 Acute Neurologic Injury in the ICU: Role of Transcranial
Doppler in Disorders of the Vertebrobasilar Circulation . . . . . . . . . 461
Rick R. Gill, Brett L. Cucchiara, and Monisha A. Kumar
28 Intracerebral Venous System: Monitoring by Transcranial
Color-Coded Duplex Sonography (TCCS) . . . . . . . . . . . . . . . . . . . . . 483
Dixon Yang, Marialaura Simonetto, Nelly Campo, Digna Cabral,
and Tatjana Rundek
29 Arteriovenous Malformation (AVM) and Arteriovenous Fistula
in the ICU: Contributions of Transcranial Doppler (TCD/TCCS)
to Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
Eva Bartels
30 Stroke Prognosis: Monitoring the Hemodynamics and Blood
Pressure by TCD/TCCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 505
Ricardo Varela, José Coelho, Sara Bernardo-Castro, Fernando Silva,
and João Sargento-Freitas

xiv
Contents
31 Acute Ischemic Stroke in ICU: Monitoring of Arterial Recanalization
After Endovascular Treatment (EVT) by Transcranial Doppler
(TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527
José I. Suárez
32 Transcranial Doppler (TCD) and Transcranial Color-Coded
Duplex Sonography (TCCS): Defining Collateral Cerebral
Blood Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Maher Saqqur
33 Reversed Robin Hood Syndrome and Ischemic Stroke:
Usefulness of Transcranial Doppler (TCD/TCCS) to
Real-Time Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569
Sanjeev Sivakumar and Ryan Hakimi
34 Ischemic Stroke in the ICU: Bedside Monitoring of the Cerebral
Autoregulation Status by Transcranial Doppler (TCD/TCCS)
in the Acute Stage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 581
Pedro Castro and Ricardo Soares-dos-Reis
35 Sonothrombolysis: Usefulness of Transcranial Doppler
Ultrasonography (TCDU) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 593
Jose C. Navarro, Cyrus G. Escabillas, and Vijay K. Sharma
36 Neurosonology in ICU: Transcranial Doppler (TCD/TCCS)
and Microemboli Detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611
Branko Malojcic
37 Stroke and Right-to-Left Shunt in ICU: Role of the Transcranial
Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621
Edoardo Vicenzini and Chiara Izzo
38 Neuro-Orbital Ultrasound: Ocular Color- Coded Duplex
Sonography (OCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639
Camilo N. Rodríguez, Milija Mijajlovic, and Juan Diego Ciro
39 Death by Neurological Criteria (DNC) in ICU: Usefulness of
Transcranial Doppler (TCD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661
José María Domínguez Roldán, Claudio García Alfaro,
and Rosa Elena de la Torre Gómez
40 Intracerebral Hemorrhage in ICU: Dynamic Monitoring by
Transcranial Color-Coded Duplex Sonography (TCCS) . . . . . . . . . 679
Pol Camps-Renom
41 Transcranial Doppler (TCD/TCCS) and Traumatic Brain
Injury (TBI): Is There a Role? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689
Pierre Bouzat and Pierluigi Banco

Contents
42 Sickle Cell Disease (SCD): Usefulness of Transcranial Doppler
(TCD/TCCS) Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 701
Juan Fernando Gómez Castro
Part IV Neurosonology: Beyond Usual Monitoring
43 Comatose Patient in ICU: Early Resuscitation Guided by
Transcranial Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . 715
Francisco Tamagnone and Ezequiel Luna
44 Post-cardiac Arrest Care: Usefulness of Transcranial Doppler
(TCD/TCCS) in Cerebral Hemodynamic Monitoring After
Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 731
C. Hoedemaekers
45 Large Hemispheric Infarction (LHI): Usefulness of
Transcranial Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . 743
Claudio E. Scherle Matamoros
46 Non-Convulsive Status Epilepticus (NCSE) in ICU: Bedside
Usefulness of TCD in Comatose Patient Diagnosis. When the
EEG Is Too Far . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 753
Alshimaa Shaban Othman and Foad Abd-Allah
47 Patient with Preeclampsia in ICU: Usefulness of the Transcranial
Doppler (TCD/TCCS) to Monitor and Predict the Most Common
Neurological Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763
Teelkien Van Veen and Ronney B. Panerai
xv
48 ECMO Patient in Intensive Care Unit: Usefulness of Neurosonology
in Neurologic Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777
Loïc Le Guennec and Alain Combes
49 Neuro-ICU: Usefulness of Transcranial Doppler (TCD/TCCS) to
Monitoring of Neurological Impact from Mechanical Ventilation
and Prone Position in ARDS Patients . . . . . . . . . . . . . . . . . . . . . . . . . 797
Anna Teresa Mazzeo, Giulia Catozzi, Simone Caccia,
and Luciana Mascia
50 Acute Liver Failure (ALF) in ICU: Usefulness of Transcranial
Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817
Anselmo A. Abdo-Cuza
51 Sepsis in the ICU: Usefulness of Transcranial Doppler
(TCD/TCCS) to Cerebral Hemodynamic Monitoring . . . . . . . . . . . . 829
Ilaria Alice Crippa and Fabio Silvio Taccone
52 Infective Endocarditis and Stroke: Active Embolization
Risk Monitoring by Transcranial Doppler (TCD/TCCS) . . . . . . . . . 841
Carla Venegas, Leilani Johnson, and Aarti Sarwal

xvi
Contents
53 Neurosurgical Patient in ICU: Usefulness of Transcranial
Doppler (TCD/TCCS) in Postoperative Monitoring . . . . . . . . . . . . . 849
Camilo N. Rodríguez and Thomas Geeraerts
54 Perioperative Cardiovascular Surgery: Transcranial Doppler
(TCD/TCCS) As a Tool in Predicting Neurological Outcome . . . . . . 887
Leandro Aguirre and Francisco Klein
55 Decompressive Craniectomy in the ICU: Usefulness of Transcranial
Doppler (TCD/TCCS) in the Monitoring of Hemodynamic
Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 905
Sebastián Vásquez, Juliana Mendoza Mantilla, María Natalia Suárez,
Luis A. Bustamante, Joffre Guzman, and Andrés M. Rubiano
56 Therapeutic Hypothermia (TH) in ICU: Cerebral Hemodynamics
Monitoring by Transcranial Doppler (TCD/TCCS) . . . . . . . . . . . . . 919
Sanjeev Sivakumar and Christos Lazaridis
57 Management of Brain Tumors in ICU: Monitoring the Neurological
Impact by Transcranial Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . 931
Mohammed F. Kananeh and Syed Omar Shah
58 Point-of-Care Ultrasound: Guidance for Lumbar Puncture . . . . . . 937
Camilo N. Rodríguez and Tiffany Fong
59 Intensive Care Unit-Acquired Weakness (ICUAW): Usefulness
of Bedside Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 949
Paolo Formenti, Michele Umbrello, and Davide Chiumello
60 POCUS Application in Neurocritical Care Patients: Transcranial
Doppler (TCD/TCCS) as a Part of POCUS, from the Brain
Ultrasound to Monitoring the Systemic Complications . . . . . . . . . . 975
Raffaele Aspide, Chiara Robba, and Federico Bilotta
61 Intra-Aortic Balloon Pump (IABP) in ICU: Cerebral Hemodynamics
Monitoring by Transcranial Doppler (TCD/TCCS) . . . . . . . . . . . . . 999
Juliana Caldas and Ronney B. Panerai
62 Brain Parenchyma: Usefulness of Transcranial Color-Coded
Duplex Sonography (TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1011
Silvana Svampa
63 ICP Management by Osmotherapy with Mannitol and Hypertonic
Saline in ICU: Real-Time Effect on Optic Nerve Sheath Diameter
Monitoring by Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1025
Yoann Launey
64 Neuroanesthesia: Usefulness of Transcranial Doppler (TCD) . . . . . 1037
Marta García-Orellana and Nicolás de Riva Solla

Contents
65 Traumatic Brain Injury in Neuro-ICU: Usefulness and
Experience of Robotic Transcranial Doppler (TCD) . . . . . . . . . . . . . 1045
Frederick A. Zeiler
66 Prehospital Transcranial Color-Coded Duplex Sonography (TCCS):
Usefulness for the Diagnosis and Early Stroke Treatment . . . . . . . . 1057
Felix Schlachetzki, Mustafa Kilic, Markus Webert, Michael Ertl,
Dobri Baldaranov, and Sandra Boy
67 Transcranial Doppler (TCD/TCCD) and Ultrasonography:
A Useful Tool in the Aeromedical Transport. What Should We
Consider? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1065
Anselmo Caricato and Eleonora Stival
68 Cerebral Hemodynamic Monitoring and Renal Replacement
Therapy (RRT) in ICU: Usefulness of the Transcranial
Doppler (TCD/TCCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1075
Camilo N. Rodríguez and Jorge Cerdá
69 Central Nervous System Infection in ICU: Usefulness of
Transcranial Doppler (TCD/TCCS) to Cerebral Hemodynamics
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1103
Martin Müller, Mareike Österreich, Lehel Lakatos,
and Manuel Bolognese
xvii
70 Pneumoperitoneum and Trendelenburg Position During
Abdominal Surgery: Usefulness of Transcranial Doppler
(TCD/TCCS) to Non-invasive Intracranial Pressure
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1111
Karthikka Chandrapatham, Chiara Robba, and Danilo Cardim
71 Transcranial Doppler (TCD): Role for Patients After
Concussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1121
Alexander Razumovsky
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1135

Contributors
RuneAaslid, PhD Hemodynamics Ag, Bern, Switzerland
Foad Abd-Allah, MD Kasr-Alainy School of Medicine, University of Cairo,
Cairo, Egypt
Anselmo A. Abdo-Cuza, MD, PhD Medical Surgical Research Center, La
Habana, Cuba
LeandroAguirre, MD Favaloro Foundation University Hospital, Buenos Aires,
Argentina
ClaudioGarcíaAlfaro, MD University Hospital of Virgen del Rocío, Seville, Spain
Pablo F. Amaya, MD Hospital Universitario Fundación Valle del Lili, Cali,
Colombia
Raffaele Aspide, MD IRCCS Istituto delle Scienze Neurologiche di Bologna,
Anesthesia and Neurointensive Care Unit, Bologna, Italy
ElsaAzevedo, MD
Health, Faculty of Medicine of University of Porto, Porto, Portugal
Department of Neurology, Universitary Hospital São João, Porto, Portugal
Committee Member - ESNCH, Oslo, Norway
Milene Azzam, MD Department of Anesthesiology, Montreal Heart Institute,
Université de Montréal, Montreal, QC, Canada
DobriBaldaranov, MD Department of Neurology, Center for Vascular Neurology
and Neurointensive Care, University of Regensburg, medbo Bezirksklinikum
Regensburg, Regensburg, Germany
PierluigiBanco, MD Anesthesiology and Intensive Care Medicine, CHU Grenoble
Alpes Trauma Center, Grenoble, France
ClaudioBaracchini, MD, FESO Director of Stroke center and Neurosonology
Lab, University of Padua School of Medicine, President - ESNH, Padova, Italy
Neurologist, Department of Clinical Neurosciences and Mental
xix

xx
Contributors
EvaBartels, MD, PhD Neurologist, Center for Neurological Vascular Diagnostics,
Munich, Germany
Educational Coordinator - ESNCH, Oslo, Norway
WilliamBeaubien-Souligny, MD Department of Anesthesiology, Montreal Heart
Institute, Université de Montréal, Montreal, QC, Canada
Department of Nephrology, Centre Hospitalier de l’Université de Montréal,
Montreal, QC, Canada
Francis Bernard, MD
Intensive Care Unit, Hôpital Sacré-Coeur de Montréal,
Montreal, QC, Canada
Sara Bernardo-Castro, MD Neurosonology Laboratory, Centro Hospitalar e
Universitário de Coimbra, Coimbra, Portugal
Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
Federico Bilotta, MD Department of Anesthesiology, Critical Care and Pain
Medicine, Section of Neuroanaesthesia and Neurocritical Care, Sapienza University
of Rome, Rome, Italy
Manuel Bolognese, MD Department of Neurology, Luzerner Kantonsspitals,
Lucerne, Switzerland
PierreBouzat, MD CHU Grenoble Alpes, Grenoble Institut of Neurosciences,
Grenoble, France
Sandra Boy, MD Department of Neurology, Asklepios Clinic Bad Tölz, Bad
Tölz, Germany
Gretchen M. Brophy, PharmD, BCPS, FCCP, FCCM, FNCS Virginia
Commonwealth University, Medical College of Virginia Campus,
Richmond, VA, USA
JoséManuel Velasco Bueno, RN Hospital Universitario Virgen de la Victoria,
Málaga, Spain
LuisA.Bustamante, MD Trauma Intensive Care Unit, San Fernando/Valle Salud
Clinic, Cali, Colombia
Digna Cabral, MD Department of Neurology, Miller School of Medicine,
University of Miami, Miami, FL, USA
SimoneCaccia, MD Department of Surgical Sciences, Division of Anesthesia and
Intensive Care, University of Turin, Turin, Italy
JulianaCaldas, MD, PhD Department of Anesthesia, University of Sao Paulo,
Butanta, Sao Paulo, Brazil
Critical Care Unit Hospital São Rafael Salvador, Salvador, Brazil

Contributors
xxi
LeanneA.Calviello, BA, MSc Division of Neurosurgery, Department of Clinical
Neurosciences, Cambridge Biomedical Campus, University of Cambridge,
Cambridge, UK
Nelly Campo, MD Department of Neurology, Miller School of Medicine,
University of Miami, Miami, FL, USA
PolCamps-Renom, MD, PhD Department of Neurology, Hospital de la Santa
Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
DaniloCardim, MD, PhD
Brain Physics Laboratory, Division of Neurosurgery,
Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of
Cambridge, Cambridge, UK
Institute for Exercise and Environmental Medicine, Texas Health Presbyterian
Hospital Dallas, Dallas, TX, USA
Department of Neurology and Neurotherapeutics, University of Texas Southwestern
Medical Center, Dallas, TX, USA
Anselmo Caricato, MD Department of Anesthesia and Intensive Care,
NeuroIntensive Care, IRCCS Policlinico Universitario “A.Gemelli”, Rome, Italy
JorgeCarrizosa, MD, MSc, NVS Intensive Care Medicine, Hospital Universitario
Fundación Santa Fé, Bogotá, Colombia
Neurointensive Care section - AMCI, Bogotá, Colombia
JuanFernandoGómezCastro, MD Pediatric Neurology Department, Hospital
Universitario Valle del Lili, Cali, Colombia
Pedro Castro, MD, PhD Department of Clinical Neurosciences and Mental
Health, Faculty of Medicine of University of Porto, Porto, Portugal
Department of Neurology and Stroke Unit, Centro Hospitalar Universitário de São
João, E.P.E, Porto, Portugal
GiuliaCatozzi, MD Department of Surgical Sciences, Division of Anesthesia and
Intensive Care, University of Turin, Turin, Italy
Jorge Cerdá, MD, MSc, FACP, FASN Nephrology Division, Department of
Medicine, Albany Medical College, Albany, NY, USA
KarthikkaChandrapatham, MD Department of Surgical Sciences and Integrated
Diagnostics, Anaesthesia and Intensive Care, San Martino Policlinico Hospital,
IRCCS for Oncology, University of Genoa, Genoa, Italy
DavideChiumello, MD SC Anestesia e Rianimazione, Ospedale San Paolo– Polo
Universitario, ASST Santi Paolo e Carlo, Milan, Italy
Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy

xxii
Contributors
Centro Ricerca Coordinata di Insufcienza Respiratoria, Università degli Studi di
Milano, Milan, Italy
Juan Diego Ciro, MD, MSc Anesthesiology – Intensive Care Medicine, ICU
Department, Clínica Las Américas, Medellin, Colombia
Neurointensive Care Section– AMCI, Bogotá, Colombia
JoséCoelho, MD Neurosonology Laboratory, Centro Hospitalar e Universitário
de Coimbra, Coimbra, Portugal
AlainCombes, MD, PhD Reanimation Service, Institute of Cardiology, Groupe
Hospital Pitié–Salpêtrière, Public Assistance – Hospital of Paris, Paris, France
Sorbonne University, UPMC University Paris 06, Institute of Cardiometabolism
and Nutrition, Paris, France
EtienneCouture, MD Department of Anesthesiology, Montreal Heart Institute,
Université de Montréal, Montreal, QC, Canada
IlariaAliceCrippa, MD Department of Intensive Care, University of Brussels,
Erasme Hospital, Brussels, Belgium
LászlóCsiba, MD, PhD, DSci, MHAS Neurologist, Department of Neurology,
Clinical Center Debrecen University, Advisory Board - ESNCH. Hungarian
Neurological Society, Debrecen, Hungary
BrettL.Cucchiara, MD Department of Neurology, University of Pennsylvania,
Philadelphia, PA, USA
Thomas J. Cusack, MD, MSc Division of Neurosciences Critical Care,
Departments of Neurology, Neurosurgery, and Critical Care Medicine, The Johns
Hopkins Hospital, Baltimore, MD, USA
Marek Czosnyka, PhD Department of Clinical Neurosciences, Cambridge
Biomedical Campus, University of Cambridge, Cambridge, UK
RosaElenade la TorreGómez, MD
National Medical Center of Western IMSS,
Guadalajara, Mexico
AndréY.Denault, MD Department of Anesthesiology and Intensive Care Unit,
Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
Nicolás de Riva Solla, MD, PhD Neuroanesthesia Division, Anesthesiology
Department, CLINIC Hospital, Barcelona, Spain
Bahattin B. Ergin, BSN, RVT Anesthesiology & Critical Care Medicine, The
Johns Hopkins University School of Medicine, Baltimore, MD, USA
Michael Ertl, MD Department of Neurology, University Clinic Augsburg,
Augsburg, Germany
Cyrus G. Escabillas, MD Jose R. Reyes Memorial Medical Center, Manila,
Philippines

Contributors
xxiii
Laura Llull Estrany, MD Cerebral Vascular Pathology Unit, Hospital Clínic,
Barcelona, Spain
DavidH.Evans, PhD, DSc Department of Cardiovascular Sciences, University of
Leicester, Leicester, UK
FilippoFarina, MD Department of Neuroscience, University of Padua School of
Medicine, Padova, Italy
FelixSchlachetzki, MD
Department of Neurology, Center for Vascular Neurology
and Neurointensive Care, University of Regensburg, medbo Bezirksklinikum
Regensburg, Regensburg, Germany
RyanFillmore, MD Department of Neurology-Neurocritical Care, The University
of California, Irvine, Orange, CA, USA
TiffanyFong, MD, FACEP Division of Emergency Ultrasound, Department of
Emergency Medicine, The Johns Hopkins University School of Medicine,
Baltimore, MD, USA
PaoloFormenti, MD SC Anestesia e Rianimazione, Ospedale San Paolo– Polo
Universitario, ASST Santi Paolo e Carlo, Milan, Italy
Marta García-Orellana, MD Neuroanesthesia Division, Anesthesiology
Department, CLINIC Hospital, Barcelona, Spain
Thomas Geeraerts, MD Department of Anesthesiology and Intensive Care,
University Hospital of Toulouse, Toulouse NeuroImaging Center (ToNIC), Inserm,
Toulouse, France
RickR.Gill, MD Department of Neurology, Loyola University, Chicago, IL, USA
Joffre Guzman, MD Neuroscience Institute, El Bosque University, INUB –
Meditech Research Group, Bogotá, Colombia
RyanHakimi, DO, MSc, FNCS, NVS Neuro ICU, TCD Services, Prisma Health-
Upstate, Greenville, SC, USA
Department of Medicine (Neurology), USC School of Medicine-Greenville,
Greenville, SC, USA
American Society of Neuroimaging (ASN), Minneapolis, MN, USA
AntoineHalwagi, MD Department of Anesthesiology and Intensive Care Unit,
Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
C.Hoedemaekers, MD, PhD Department of Intensive Care, Radboud University
Medical Center, Nijmegen, The Netherlands
ChiaraIzzo, MD Department of Neurosciences and Mental Health, Neurosonology,
Sapienza, University of Rome, Rome, Italy
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