title: Transcranial Doppler ultrasound in the diagnosis of brain death. Is it useful or does it delay the diagnosis?
abstract: Transcranial Doppler ultrasound is able to demonstrate cerebral circulatory arrest associated to brain death, being especially useful in sedated patients, or in those in which complete neurological exploration is not possible. Transcranial Doppler ulstrasound is a portable, noninvasive and high-availability technique. Among its limitations, mention must be made of the absence of acoustic windows and false-negative cases. In patients clinically diagnosed with brain death, with open skulls or with anoxia as the cause of death, cerebral blood flow can be observed by ultrasound, since cerebral circulatory arrest is not always synchronized to the clinical diagnosis. The diagnostic rate is therefore time-dependent, and this fact that must be recognized in order to avoid delays in death certification. Despite its limitations, transcranial Doppler ulstrasound helps solve common diagnostic problems, avoids the unnecessary consumption of resources, and can optimize organ harvesting for transplantation.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: dolores.escudero@sespa.princast.es.
authors.forename: D
authors.initials: D
authors.lastname: Escudero
authors.affiliation: Unidad de Coordinación de Trasplantes y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: J
authors.initials: J
authors.lastname: Otero
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: B
authors.initials: B
authors.lastname: Quindós
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: L
authors.initials: L
authors.lastname: Viña
mesh_terms: D016477:Artifacts; D001783:Blood Flow Velocity; D001926:Brain Death / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000331:legislation & jurisprudence; D002560:Cerebrovascular Circulation; D000075202:Contraindications; D003399:Craniotomy; D003644:Death Certificates; D057210:Delayed Diagnosis; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D002534:Hypoxia, Brain / Q000503:physiopathology; D019586:Intracranial Hypertension / Q000503:physiopathology; D013030:Spain; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence; D017585:Ultrasonography, Doppler, Transcranial
keywords: Brain death; Diagnosis; Diagnóstico; Donante de órganos; Doppler transcraneal; Muerte encefálica; Organ donor; Transcranial Doppler