Cardiovascular Anesthesia and Intensive Care, Alessandro Manzoni Hospital of Lecco, Italy.
J Cardiovasc Med (Hagerstown). 2013 Aug;14(8):597-602. doi: 10.2459/JCM.0b013e328356a485.
Hypothermia in combination with selective cerebral perfusion is a well-documented technique for cerebral protection during aortic arch surgery. However, such complex surgery is still accompanied by a considerable incidence of neurological events.
This study describes the advantages of transcranial color Doppler ultrasound (TCDU) as a noninvasive real-time method for intraoperative monitoring of cerebral blood flow.
Between 1 January 2010 and 31 December 2011, 29 consecutive patients underwent transcranial echo color Doppler (TCDU) monitoring during hypothermic circulatory arrest.
TCDU was easily applied and provided continuous information on cerebral perfusion in all patients studied. Early detection of perfusion abnormalities during selective cerebral perfusion guided surgeon and anesthesiologist to research for causes and correct them, avoiding severe neurological consequences. Moreover, transcranial echo color Doppler allowed us to optimize anterograde and retrograde cerebral perfusion rate, avoiding hyper-perfusion or hypo-perfusion phenomena during cardiac arrest.
低温结合选择性脑灌注是主动脉弓手术中脑保护的一种已有充分文献记载的技术。然而，如此复杂的手术仍然伴随着相当高的神经系统事件发生率。
本研究描述了经颅彩色多普勒超声（TCDU）作为术中脑血流监测的一种非侵入性实时方法的优势。
2010 年 1 月 1 日至 2011 年 12 月 31 日，29 例连续患者在低温循环停止期间接受经颅回声彩色多普勒（TCDU）监测。
TCDU 易于应用，并为所有研究患者提供了连续的脑灌注信息。在选择性脑灌注期间，对灌注异常的早期检测指导外科医生和麻醉师寻找并纠正原因，避免严重的神经后果。此外，经颅回声彩色多普勒允许我们优化顺行和逆行脑灌注率，避免心脏骤停期间的高灌注或低灌注现象。
