Title |
Point-of-care transcranial Doppler by intensivists
|
---|---|
Published in |
Critical Ultrasound Journal, October 2017
|
DOI | 10.1186/s13089-017-0077-9 |
Pubmed ID | |
Authors |
Vincent Issac Lau, Robert Thomas Arntfield |
Abstract |
In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimensional transcranial Doppler imaging of the brain have the potential to be a middle ground to bridge this gap for certain diagnoses. With the increasing availability of point-of-care ultrasound devices, coupled with the need for rapid diagnosis of deteriorating neurologic patients, intensivists may be trained to perform point-of-care transcranial Doppler at the bedside. The feasibility and value of this technique in the intensive care unit to help rule-in specific intra-cranial pathologies will form the focus of this article. The proposed scope for point-of-care transcranial Doppler for the intensivist will be put forth and illustrated using four representative cases: presence of midline shift, vasospasm, raised intra-cranial pressure, and progression of cerebral circulatory arrest. We will review the technical details, including methods of image acquisition and interpretation. Common pitfalls and limitations of point-of-care transcranial Doppler will also be reviewed, as they must be understood for accurate diagnoses during interpretation, as well as the drawbacks and inadequacies of the modality in general. |
Twitter Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 28 | 18% |
Canada | 18 | 11% |
United Kingdom | 14 | 9% |
Mexico | 9 | 6% |
Spain | 6 | 4% |
Brazil | 4 | 3% |
Australia | 4 | 3% |
Saudi Arabia | 4 | 3% |
Malaysia | 3 | 2% |
Other | 23 | 15% |
Unknown | 45 | 28% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 95 | 60% |
Practitioners (doctors, other healthcare professionals) | 44 | 28% |
Scientists | 13 | 8% |
Science communicators (journalists, bloggers, editors) | 5 | 3% |
Unknown | 1 | <1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 160 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 26 | 16% |
Other | 25 | 16% |
Student > Ph. D. Student | 17 | 11% |
Researcher | 15 | 9% |
Unspecified | 9 | 6% |
Other | 40 | 25% |
Unknown | 28 | 18% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 91 | 57% |
Neuroscience | 11 | 7% |
Unspecified | 9 | 6% |
Engineering | 3 | 2% |
Agricultural and Biological Sciences | 2 | 1% |
Other | 7 | 4% |
Unknown | 37 | 23% |