Cerebral flow pattern monitoring by transcranial Doppler during cardiopulmonary resuscitation

• Published in: Anaesthesia and intensive care Vol. 38; no. 2; pp. 376 - 380
• Main Authors: BLUMENSTEIN, J, KEMPFERT, J, WALTHER, T, VAN LINDEN, A, FASSL, J, BORGER, M, MOHR, F. W
• Format: Journal Article
• Language: English
• Published: Edgecliff Anaesthesia Society of Anaesthetists 01-03-2010; Sage Publications Ltd. (UK); Sage Publications Ltd
• Subjects: Aged; Aged, 80 and over; Analysis; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aortic Valve - surgery; Biological and medical sciences; Cardiopulmonary Resuscitation; Case studies; Cerebral circulation; Cerebrovascular Circulation; CPR (First aid); Female; Humans; Medical sciences; Monitoring, Physiologic; Patient monitoring; Patient outcomes; Physiological aspects; Transcranial Doppler ultrasonography; Ultrasonography, Doppler, Transcranial; cardiopulmonary resuscitation; transcranial Doppler; Anesthesia; cerebral blood flow; Monitoring; Resuscitation; Blood flow; Encephalon
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x1003800223

We describe the transcranial Doppler pattern during a period of cardiopulmonary resuscitation in a patient undergoing a transcatheter off-pump aortic valve implantation. Transcranial Doppler of the middle cerebral artery flow was measured as a part of a separate ongoing study. The patient developed a cardiac arrest during deployment of the valve prosthesis. The incidental presence of the transcranial Doppler allowed us to assess middle cerebral artery flow during cardiopulmonary resuscitation in real time. An initial lack of a diastolic flow pattern seen with transcranial Doppler at the beginning of cardiopulmonary resuscitation led to volume loading and optimisation of the resuscitation technique. After increasing the depth of external cardiac massage, the cerebral flow pattern improved to produce sufficient diastolic flow. The transcranial Doppler provided additional information during cardiopulmonary resuscitation, which was helpful in clinical management. The use of transcranial Doppler may be helpful for other cardiac procedures where cerebral malperfusion may occur.