TAILIEUCHUNG - Critical care ultrasound and basic transesophageal: Part 2

(BQ) Contiued part 1, part 2 of the document Critical care ultrasound and basic transesophageal has contents: Training guidelines and simulation, ultrasound-guided vascular access and examination, ultrasound for critical care procedures, critical care examination of the abdomen, critical care examination of the cardiovascular system, . And other contents. Invite you to refer. | niMVd Chapter 13 Critical Care Ultrasound Examination of the Nervous System Andrea Rigamonti Robert Chen Ramamani Mariappan and Céline Odier INTRODUCTION Monitoring cardiovascular and respiratory function is an important aspect of patient management in the intensive care unit ICU and operating room. Cardiovascular and pulmonary functions are continuously monitored during anesthesia and in critical care but the monitoring of cerebrovascular function is not routinely performed. With the availability of non-invasive monitors like transcranial Doppler TCD quantitative electroencephalographic monitoring and near-infrared spectroscopy continuous monitoring of cerebrovascular function is possible. Patient care can be enhanced when the information collected from these monitors are used to guide patient management. In this chapter the role of ultrasound US in examining the central nervous system including TCD US of the optic nerve and direct visualization of the brain using 2D echography will be presented. TRANSCRANIAL DOPPLER ULTRASOUND Transcranial Doppler US is a simple non-invasive relatively cheap bedside tool that can provide real-time dynamic information regarding cerebral blood flow velocity in the basal cerebral blood vessels. Since the first clinical application in 1982 1 the use of TCD has expanded rapidly over the past two decades. The portability and non-invasive nature of TCD allows both monitoring during emergencies and serial monitoring in the ICU. The clinical applications of TCD are summarized in Table . Transcranial Doppler is currently used in neuro-critical care units acute stroke units operating rooms emergency departments and even in outpatient settings to assess the hemodynamic changes associated with stenosis of large cerebral arteries or to determine patients at risk of stroke with sickle cell disease. For the experienced vascular neurologist neuro-intensivist and neuro-anesthesiologist the small portable TCD device serves as a stethoscope for

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