Validez del Doppler transcraneal en el diagnóstico de muerte encefálica / Validation of transcranial Doppler in the diagnosis of brain death
Rev. méd. Chile
;
138(4): 406-412, abr. 2010. ilus, tab
Article
in Spanish
| LILACS
| ID: lil-553210
ABSTRACT
Background:
The clinical diagnosis of brain death is complex.Aim:
To evaluate the diagnostic accuracy of transcranial Doppler (TCD) for brain death. Patients andMethods:
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 percent), 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 percent 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.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Brain Death
/
Ultrasonography, Doppler, Transcranial
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2010
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Clínica Alemana de Santiago/CL
/
Clínica Alemana de Temuco/CL
/
Hospital Padre Hurtado/CL
/
Hospital de Valdivia/CL
/
Universidad del Desarrollo-Clínica Alemana/CL
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