title: Transcranial doppler and near infrared spectroscopy in the perioperative period.
abstract: OBJECTIVE
  Maintenance of adequate blood flow and oxygen to the brain is one of the principal endpoints of all surgery and anesthesia. During operations in general anesthesia, however, the brain is at particular risk for silent ischemia. Despite this risk, the brain still remains one of the last monitored organs in clincial anesthesiology.
  
  
  RESULTS
  Transcranial Doppler (TCD) sonography and near-infrared spectroscopy (NIRS) experience a revival as these noninvasive technologies help to detect silent cerebral ischemia. TCD allows for quantification of blood flow velocities in basal intracranial arteries. TCD-derived variables such as the pulsatility index might hint toward diminished cognitive reserve or raised intracranial pressure. NIRS allows for assessment of regional cerebral oxygenation. Monitoring should be performed during high-risk surgery for silent cerebral ischemia and special circumstances during critical care medicine. Both techniques allow for the assessment of cerebrovascular autoregulation and individualized management of cerebral hemodynamics.
  
  
  CONCLUSIONS
  TCD and NIRS are noninvasive monitors that anesthesiologists apply to tailor cerebral oxygen delivery, aiming to safeguard brain function in the perioperative period.
authors: aDepartment of Anesthesiology, General Intensive Care and Pain Management, Medical University of Vienna, Austria bDepartment of Anesthesiology, Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
authors: Stephanie
authors: S
authors: Kampf
authors: Patrick
authors: P
authors: Schramm
authors: Klaus Ulrich
authors: KU
authors: Klein
mesh_terms: D001921:Brain / Q000378:metabolism; D001926:Brain Death / Q000175:diagnosis; D002545:Brain Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D006348:Cardiac Surgical Procedures; D002560:Cerebrovascular Circulation; D006801:Humans; D019635:Neurosurgical Procedures; D010100:Oxygen / Q000378:metabolism; D059035:Perioperative Period; D019265:Spectroscopy, Near-Infrared; D017585:Ultrasonography, Doppler, Transcranial; D014656:Vascular Surgical Procedures
chemical_list: D010100:Oxygen