Validez del Doppler transcraneal en el diagnóstico de muerte encefálica

Background: The clinical diagnosis of brain death is complex. Aim: To evaluate the diagnostic accuracy of transcranial Doppler (TCD) for brain death. Patients and Methods: Patients seen on the intensive care unit of a private hospital between January 2004 to December 2008, were included if they were...

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Autores principales:	BRUNSER,ALEJANDRO, HOPPE,ARNOLD, CÁRCAMO,DANIEL A, LAVADOS,PABLO M, ROLDÁN,ANDRÉS, RIVAS,RODRIGO, VALENZUELA,MARCELA, MONTES,JOSÉ MIGUEL
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2010
Materias:	Brain, death Intensive care units Transcranial Doppler
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400003
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spelling	oai:scielo:S0034-988720100004000032010-06-30Validez del Doppler transcraneal en el diagnóstico de muerte encefálicaBRUNSER,ALEJANDROHOPPE,ARNOLDCÁRCAMO,DANIEL ALAVADOS,PABLO MROLDÁN,ANDRÉSRIVAS,RODRIGOVALENZUELA,MARCELAMONTES,JOSÉ MIGUEL Brain, death Intensive care units Transcranial Doppler Background: The clinical diagnosis of brain death is complex. Aim: To evaluate the diagnostic accuracy of transcranial Doppler (TCD) for brain death. Patients and Methods: Patients seen on the intensive care unit of a private hospital between January 2004 to December 2008, were included if they were in structural coma, had no craniectomy and had a blind evaluation by a neurologist and TCD done in less than three hours. The diagnosis of brain death was based on a clinical evaluation that considered the absence of sedative drugs, median blood pressure >60 mmHg, body temperature over 35º Celsius and complete absence of brainstem refexes. An expert neurosonologist, with a TCD-PMD-100, 2 Mhz transducer, used an institutional protocol that considers the examination as positive for brain circulatory arrest when there is presence of reverberating, small systolic peaks or the disappearance of a previous signal present on both middle cerebral arteries and intracranial vertebral arteries. Results: Fifty three patients were evaluated, 25 with clinical brain death. On 45 cases (84.9%), the interval between both evaluations was less than one hour. The sensitivity, specifcity, positive and negative predictive values for the diagnosis of brain death with TCD were 100, 96, 96.1 and 100% respectively. Positive and negative likelihood ratios for brain death were 28 and 0, respectively. Conclusions: TCD is a valid and useful technique for the diagnosis of brain death and can be used on complicated cases.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.138 n.4 20102010-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400003es10.4067/S0034-98872010000400003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Brain, death Intensive care units Transcranial Doppler
spellingShingle	Brain, death Intensive care units Transcranial Doppler BRUNSER,ALEJANDRO HOPPE,ARNOLD CÁRCAMO,DANIEL A LAVADOS,PABLO M ROLDÁN,ANDRÉS RIVAS,RODRIGO VALENZUELA,MARCELA MONTES,JOSÉ MIGUEL Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
description	Background: The clinical diagnosis of brain death is complex. Aim: To evaluate the diagnostic accuracy of transcranial Doppler (TCD) for brain death. Patients and Methods: Patients seen on the intensive care unit of a private hospital between January 2004 to December 2008, were included if they were in structural coma, had no craniectomy and had a blind evaluation by a neurologist and TCD done in less than three hours. The diagnosis of brain death was based on a clinical evaluation that considered the absence of sedative drugs, median blood pressure >60 mmHg, body temperature over 35º Celsius and complete absence of brainstem refexes. An expert neurosonologist, with a TCD-PMD-100, 2 Mhz transducer, used an institutional protocol that considers the examination as positive for brain circulatory arrest when there is presence of reverberating, small systolic peaks or the disappearance of a previous signal present on both middle cerebral arteries and intracranial vertebral arteries. Results: Fifty three patients were evaluated, 25 with clinical brain death. On 45 cases (84.9%), the interval between both evaluations was less than one hour. The sensitivity, specifcity, positive and negative predictive values for the diagnosis of brain death with TCD were 100, 96, 96.1 and 100% respectively. Positive and negative likelihood ratios for brain death were 28 and 0, respectively. Conclusions: TCD is a valid and useful technique for the diagnosis of brain death and can be used on complicated cases.
author	BRUNSER,ALEJANDRO HOPPE,ARNOLD CÁRCAMO,DANIEL A LAVADOS,PABLO M ROLDÁN,ANDRÉS RIVAS,RODRIGO VALENZUELA,MARCELA MONTES,JOSÉ MIGUEL
author_facet	BRUNSER,ALEJANDRO HOPPE,ARNOLD CÁRCAMO,DANIEL A LAVADOS,PABLO M ROLDÁN,ANDRÉS RIVAS,RODRIGO VALENZUELA,MARCELA MONTES,JOSÉ MIGUEL
author_sort	BRUNSER,ALEJANDRO
title	Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
title_short	Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
title_full	Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
title_fullStr	Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
title_full_unstemmed	Validez del Doppler transcraneal en el diagnóstico de muerte encefálica
title_sort	validez del doppler transcraneal en el diagnóstico de muerte encefálica
publisher	Sociedad Médica de Santiago
publishDate	2010
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000400003
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Validez del Doppler transcraneal en el diagnóstico de muerte encefálica

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