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The relevance of early TCD monitoring in the intensive care units for the confirming of brain death diagnosis

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Abstract

Brain death (BD) diagnosis is the clinical assessment of the irreversible loss of function of the entire brain, including the brainstem. Transcranial Doppler (TCD) examination is used in several countries as a confirmatory test to assess cerebral circulatory arrest (CCA). A total of 1,400 TCD examinations were performed in 623 patients (pts) admitted to intensive care units (ICUs) of our hospital during the last 6 years. Oscillating flow, systolic spikes and the absence of any TCD signal were considered as diagnostic patterns of irreversible CCA. TCD patterns of CCA were detected in 56 pts. In 25 pts, deeply sedated with barbiturate therapy, TCD was employed as confirmatory test for BD diagnosis and 14 of them could become organ and/or tissue donors. TCD is a safe and inexpensive tool that can be performed at the bedside, and it allows to shorten the diagnostic process of BD, which is the prerequisite for organ donation.

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Acknowledgments

The authors wish to thank the Italian Society of Neurosonology and Cerebral Hemodynamics for its cultural support.

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Authors and Affiliations

  1. Department of Neurological and Psychiatrics Sciences, University of Florence, Viale Morgagni, 85, 50134, Florence, Italy

    Marinella Marinoni, Fabiana Alari, Veronica Mastronardi & Paola Innocenti

  2. Emergency Department, University of Florence, Florence, Italy

    Adriano Peris

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  1. Marinella Marinoni
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  2. Fabiana Alari
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  3. Veronica Mastronardi
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  4. Adriano Peris
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  5. Paola Innocenti
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Correspondence to Marinella Marinoni.

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Marinoni, M., Alari, F., Mastronardi, V. et al. The relevance of early TCD monitoring in the intensive care units for the confirming of brain death diagnosis. Neurol Sci 32, 73–77 (2011). https://doi.org/10.1007/s10072-010-0407-1

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  • DOI: https://doi.org/10.1007/s10072-010-0407-1

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