PMID: 15247999Jul 13, 2004Paper

Intraoperative transcranial ultrasonic monitoring for cardiac and vascular surgery

Seminars in Cardiothoracic and Vascular Anesthesia
D D Doblar

Abstract

The brain is the only organ not routinely monitored by any direct method during the administration of anesthesia. Anesthesiologists rely primarily on indirect physiologic evidence provided by blood pressure, peripheral pulse oximetry, heart rate, and respiratory and anesthetic gas concentrations to determine that brain blood flow and oxygenation are adequate. The reasons for this practice are that: (1) after millions of anesthetics significant numbers of adverse neurologic outcomes have not occurred, (2) the interpretation of transcranial Doppler, electroencephalogram, and near-infrared cerebral oximetry requires experienced personnel, and (3) the evidence of cost-benefit to support monitoring is limited. Brain monitoring generally has been confined to procedures where the brain is exposed to unique insults and risks specific to the procedures and where reliance on indirect physiologic evidence of cerebral integrity has been proven to be unreliable. Transcranial Doppler monitoring is valuable in the assessment of established surgical techniques, refinement of recent surgical techniques, and development of new techniques and instrumentation. Brain monitoring with transcranial Doppler is of particular value when deviations from e...Continue Reading

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Citations

Jan 10, 2014·Annals of Cardiac Anaesthesia·Alexander J C Mittnacht, Cesar Rodriguez-Diaz
Dec 24, 2015·The Annals of Thoracic Surgery·Tamer GhazyUtz Kappert
Jan 24, 2014·International Journal of Vascular Medicine·Jawad NaqviJonathan Ghosh
May 28, 2005·Seminars in Cardiothoracic and Vascular Anesthesia·John M Murkin
Jul 13, 2004·Seminars in Cardiothoracic and Vascular Anesthesia·John M Murkin
Apr 6, 2018·Anesthesiology·Miles BergerJoseph P Mathew
Apr 30, 2020·Current Opinion in Critical Care·Matthias NoitzMartin W Dünser
Oct 20, 2020·Journal of Neurosurgical Anesthesiology·Chiara RobbaDeepak Sharma

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