ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020
Transcranial Doppler as a non-invasive method to estimate cerebral perfusion pressure in children with severe traumatic brain injury.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Feasibility of non-invasive neuromonitoring in general intensive care patients using a multi-parameter transcranial Doppler approach.Journal of clinical monitoring and computing · 2022Trial
- Paediatric and adult neurological point-of-care ultrasound: Review of the evidence, and the UK accreditation pathway.Journal of the Intensive Care Society · 2026Article
- Clinical Applications of Point-of-Care and Diagnostic Transcranial Doppler in the Pediatric Acute Care Setting: A Scoping Review.Neurocritical care · 2026Article
- Transcranial Doppler: The Bedside Window to Explore Cerebral Hemodynamics.Indian pediatrics · 2025Article
- Intracranial Pressure and Cerebral Hemodynamics in Infants Before and After Glenn Procedure.Critical care explorations · 2024Article
- Neuromonitoring in Children with Traumatic Brain Injury.Neurocritical care · 2024Review
- An update on pediatric traumatic brain injury.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- Multimodal and autoregulation monitoring in the neurointensive care unit.Frontiers in neurology · 2023Review
- Transcranial Doppler Ultrasound, a Review for the Pediatric Intensivist.Children (Basel, Switzerland) · 2022Review
- Evaluation on the application of transcranial Doppler (TCD) and electroencephalography (EEG) in patients with vertebrobasilar insufficiency.Journal of orthopaedic surgery and research · 2020Article
- Non-invasive estimation of cerebral perfusion pressure using transcranial Doppler ultrasonography in children with severe traumatic brain injury.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
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Authors and funding
5 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCerebral perfusion pressure (CPP) is one of the most important parameters in preventing ischemic brain insults. Guidelines have used CPP values to guide treatment of traumatic brain injury (TBI) for many years. We tested the feasibility of a novel non-invasive method for CPP estimation (nCPP) in children with severe TBI.
methodsRetrospective analysis of prospectively monitored pediatric TBI patients with invasive intracranial pressure (ICP) monitoring, arterial blood pressure, and Transcranial Doppler (TCD) studies was performed daily. A novel estimator of CPP (nCPP) was calculated using TCD-spectral accounting method. We analyzed the correlation coefficient and correlation in time domain between CPP and nCPP, prediction ability of nCPP to detect low CPP, and the confidence intervals for CPP prediction (95% CI).
resultsWe retrospectively analyzed 69 TCD recordings from 19 children (median age 15 years, range 3-16 years). There was a good correlation between CPP and nCPP (Spearman correlation coefficient, R = 0.67 (p < 0.0001), and a good mean correlation in time domain (R = 0.55 ± 0.42). The ability of nCPP to predict values of CPP below 70 mmHg was excellent as demonstrated by an area under the curve of 0.908 (95% CI = 0.83-0.98) using a receiver operating curve analysis. Bland-Altman analysis revealed that nCPP overestimated CPP by 19.61 mmHg with a wide 95% CI of ± 40.4 mmHg.
conclusionsnCPP monitoring with TCD appears to be a feasible method for CPP assessment in pediatric TBI. The novel spectral CPP tested in this study has a decent correlation with invasive CPP and can predict low CPP with excellent accuracy at the 70-mmHg threshold.
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