title: Noninvasive estimation of cerebral perfusion pressure with transcranial Doppler ultrasonography in traumatic brain injury.
abstract: OBJECTIVE
  In traumatic brain injury (TBI) patients, to overcome the secondary insults, cerebral perfusion pressure (CPP) oriented therapy is recommended. The study is assigned to estimate CPP values with middle cerebral artery (MCA) flow velocities measured noninvasively using transcranial Doppler ultrasonography (TCD).
  
  
  METHODS
  Forty-seven TBI patients were studied. Intracranial pressure (ICP), mean arterial pressure (MAP) and MCA flow velocities of the patients were monitored. Invasive CPP was calculated as the difference between MAP and ICP. The formula : 'MAP x FVd/FVm +14' was used to estimate CPP noninvasively. Correlation of the noninvasive and invasive values were analysed.
  
  
  RESULTS
  The mean values of noninvasive CPP and invasive CPP were 66.10 ± 10.55 mmHg and 65.40 ± 10.03 mmHg respectively. The correlation between noninvasive and invasive CPP measurements was strongly significant (p < 0.001) with a correlation coefficient of r = 0.920.
  
  
  CONCLUSIONS
  With ICP monitoring systems, CPP is calculated and the therapy is guided according to these values. As it is recognized that brain perfusion can be assessed with TCD waveforms, noninvasive CPP estimation with MCA flow velocities may help to observe the trends in CPP values.
authors: M.H. Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
authors: Melek
authors: M
authors: Gura
authors: Gokalp
authors: G
authors: Silav
authors: Nejat
authors: N
authors: Isik
authors: Ilhan
authors: I
authors: Elmaci
mesh_terms: D000328:Adult; D062186:Arterial Pressure; D001794:Blood Pressure / Q000502:physiology*; D020201:Brain Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010477:Perfusion; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*