Bidkar Prasanna Udupi, Kannabiran Narmadhalakshmi, Chatterjee Protiti
Professor & Unit Head (Neuroanesthesiology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India.
ICU Registrar, Fairfield Hospital, Sydney, New South Wales, United Kingdom.
Med J Armed Forces India. 2024 Jan-Feb;80(1):16-28. doi: 10.1016/j.mjafi.2023.06.007. Epub 2023 Aug 14.
Ultrasonography (USG) has become an invaluable tool in the assessment of neurocritical patients in the operating theaters and critical care units. Due to its easy availability, reliability, safety, and repeatability, neuro-intensivists and neuro-anesthesiologists utilize USG to make a diagnosis, assess prognosis, and decide upon treatment. In neurocritical care units, USG has myriad indications for use, both systemic and neurologic. The neurological indications include the assessment of stroke, vasospasm, traumatic brain injury, brain death, acute brain damage, optic nerve sheath diameter, and pupillary reflexes to name a few. The systemic indications range from assessment of cardio-pulmonary function and intravascular volume status to detection of deep venous thromboses, vocal cord assessment in intubated patients, placement of central venous catheters, and percutaneous tracheostomy. In this narrative review, we iterate the clinical applications of USG in neuroanesthesia and neurocritical care, which we penned after searching relevant databases in PubMed, Medline, Ovid, and Google Scholar by using terms such as ‘applications of transcranial Doppler’, ‘optic nerve sheath diameter’, ‘USG applications in the critical care unit’, and so on. Our search database includes several research papers, neurocritical care books, review articles, and scientific databases. This article reviews various applications of USG in neuroanesthesia, neurosurgery, and neurocritical care.
超声检查(USG)已成为手术室和重症监护病房评估神经危重症患者的一项宝贵工具。由于其易于获取、可靠性高、安全性好且可重复性强,神经重症医生和神经麻醉医生利用超声检查进行诊断、评估预后并决定治疗方案。在神经重症监护病房,超声检查在全身和神经系统方面有众多应用指征。神经系统方面的指征包括评估中风、血管痉挛、创伤性脑损伤、脑死亡、急性脑损伤、视神经鞘直径以及瞳孔反射等。全身方面的指征范围从评估心肺功能和血管内容量状态到检测深静脉血栓形成、评估插管患者的声带、放置中心静脉导管以及经皮气管切开术。在这篇叙述性综述中,我们阐述了超声检查在神经麻醉和神经重症监护中的临床应用,这些内容是我们在通过使用“经颅多普勒的应用”“视神经鞘直径”“超声检查在重症监护病房的应用”等术语检索PubMed、Medline、Ovid和谷歌学术等相关数据库后撰写的。我们的检索数据库包括多篇研究论文、神经重症监护书籍、综述文章以及科学数据库。本文综述了超声检查在神经麻醉、神经外科和神经重症监护中的各种应用。