Accuracy of Power Mode TranscranialDoppler in the Diagnosis of Brain Death
Date
2015
Type:
Article
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Abstract
Background:The diagnosis of brain death (BD) is complex. For this reason, we aimed toevaluate the accuracy of power mode transcranial Doppler (PMD-TCD) in diagnosing BD.Patients and methods:Patients admitted to an intensive care unit between December 2003and January 2012 were included in this study if they were in a structural coma, had nocraniectomy, and were evaluated blind by a neurologist using PMD-TCD. The diagnosis of BDwas based on an evaluation that took into consideration the absence of sedative drugs, amedian blood pressure>60 mmHg, a body temperature>35 C, and the absence of brainstemreflexes. A neurosonologist followed a protocol using PMD-TCD that considered the examina-tion as positive for brain circulatory arrest given the presence of reverberating, small systolicpeaks or the disappearance of a previous signal present in both middle cerebral arteries andintracranial vertebral arteries.Results:A total of 74 patients were evaluated. In 61 (82.4%) patients the interval betweenboth evaluations was less than 1 hour. The sensitivity and specificity for the diagnosis of BD with PMD-TCD were 100% and 98%, respectively. The positive and negative likelihood ratios forBD were 45 and 0, respectively.Conclusion:PMD-TCD is accurate for the diagnosis of BD.
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Citation
Alejandro M. Brunser, Pablo M. Lavados, Daniel A. Cárcamo, Arnold Hoppe, Verónica V. Olavarría, Javiera López, Paula Muñoz, Rodrigo Rivas, Accuracy of Power Mode Transcranial Doppler in the Diagnosis of Brain Death, Journal of Medical Ultrasound, Volume 23, Issue 1, 2015, Pages 29-33,
Keywords
Brain death, Doppler ultrasound, Power mode transcranial Doppler ultrasound, Ultrasound Doppler sonography, Ultrasound diagnosis