title: Review of transcranial Doppler ultrasound to detect microemboli during orthopedic surgery.
abstract: Transcranial Doppler ultrasonography has been used to detect microemboli in the middle cerebral artery during orthopedic surgery. We conducted a comprehensive systematic literature review of transcranial Doppler ultrasonography in orthopedic surgery to evaluate its status in this setting. Fourteen studies were selected for qualitative analysis. The highest number of patients studied was 45; emboli were detected in all studies, occurring in 20%-100% of patients. Most embolic counts were below 10, but some high counts were noted. No study reported all the technical parameters of the transcranial Doppler ultrasonography. All studies assessed neurologic status, and 6 studies evaluated cognitive function postoperatively. No study identified an association between postoperative cognitive function and embolic count. Six studies sought the presence of right-to-left shunts.
authors: From the Department of Anaesthesia (B.S.S., L.A.E., D.A.S., S.R.), Centre for Anaesthesia and Cognitive Function, St. Vincent's Hospital, Melbourne, Australia Department of Anaesthesia (B.S.S., L.A.E., D.A.S.), Perioperative and Pain Medicine Unit, Melbourne Medical School brendan.silbert@svhm.org.au.
authors: B S
authors: BS
authors: Silbert
authors: From the Department of Anaesthesia (B.S.S., L.A.E., D.A.S., S.R.), Centre for Anaesthesia and Cognitive Function, St. Vincent's Hospital, Melbourne, Australia Department of Anaesthesia (B.S.S., L.A.E., D.A.S.), Perioperative and Pain Medicine Unit, Melbourne Medical School.
authors: L A
authors: LA
authors: Evered
authors: From the Department of Anaesthesia (B.S.S., L.A.E., D.A.S., S.R.), Centre for Anaesthesia and Cognitive Function, St. Vincent's Hospital, Melbourne, Australia Department of Anaesthesia (B.S.S., L.A.E., D.A.S.), Perioperative and Pain Medicine Unit, Melbourne Medical School.
authors: D A
authors: DA
authors: Scott
authors: From the Department of Anaesthesia (B.S.S., L.A.E., D.A.S., S.R.), Centre for Anaesthesia and Cognitive Function, St. Vincent's Hospital, Melbourne, Australia.
authors: S
authors: S
authors: Rahardja
authors: Epworth Healthcare (R.P.G.), Richmond, Victoria, Australia Department of Medicine (R.P.G.), Epworth HealthCare, Monash University, Melbourne, Australia.
authors: R P
authors: RP
authors: Gerraty
authors: Department of Surgery (P.F.C.), University of Melbourne, Melbourne, Australia.
authors: P F
authors: PF
authors: Choong
mesh_terms: D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D009985:Orthopedics; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*
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