Transcranial Doppler Pulsatility Index: What it is and What it Isn't.

Détails

ID Serval
serval:BIB_D61803591CB0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Transcranial Doppler Pulsatility Index: What it is and What it Isn't.
Périodique
Neurocritical Care
Auteur(s)
de Riva N., Budohoski K.P., Smielewski P., Kasprowicz M., Zweifel C., Steiner L.A., Reinhard M., Fábregas N., Pickard J.D., Czosnyka M.
ISSN
1556-0961 (Electronic)
ISSN-L
1541-6933
Statut éditorial
Publié
Date de publication
2012
Volume
17
Numéro
1
Pages
58-66
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
BACKGROUND: Transcranial Doppler (TCD) pulsatility index (PI) has traditionally been interpreted as a descriptor of distal cerebrovascular resistance (CVR). We sought to evaluate the relationship between PI and CVR in situations, where CVR increases (mild hypocapnia) and decreases (plateau waves of intracranial pressure-ICP).
METHODS: Recordings from patients with head-injury undergoing monitoring of arterial blood pressure (ABP), ICP, cerebral perfusion pressure (CPP), and TCD assessed cerebral blood flow velocities (FV) were analyzed. The Gosling pulsatility index (PI) was compared between baseline and ICP plateau waves (n = 20 patients) or short term (30-60 min) hypocapnia (n = 31). In addition, a modeling study was conducted with the "spectral" PI (calculated using fundamental harmonic of FV) resulting in a theoretical formula expressing the dependence of PI on balance of cerebrovascular impedances.
RESULTS: PI increased significantly (p < 0.001) while CVR decreased (p < 0.001) during plateau waves. During hypocapnia PI and CVR increased (p < 0.001). The modeling formula explained more than 65% of the variability of Gosling PI and 90% of the variability of the "spectral" PI (R = 0.81 and R = 0.95, respectively).
CONCLUSION: TCD pulsatility index can be easily and quickly assessed but is usually misinterpreted as a descriptor of CVR. The mathematical model presents a complex relationship between PI and multiple haemodynamic variables.
Pubmed
Web of science
Création de la notice
18/08/2012 10:56
Dernière modification de la notice
20/08/2019 16:55
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