Cranial Doppler applications in neonatal critical care

Although Doppler methods have been validated, it must be stressed that, at their best, Doppler results reflect qualitative circulatory changes, and suggest the direction of change. Because the large conduit arteries may also be controlling changes in flow volume, a direct extrapolation of the numeric findings from Doppler studies may lead to incorrect conclusions. Doppler methods have not made their way into routine neonatal critical care until now, but several studies have concluded that Doppler-derived information can be used as adjunct to clinical management in cases with shock, asphyxia, brain death, vascular malformations, and increased intracranial pressure. As with any physiologic variable, serial measurements may be of greater value than a single measurement. The Doppler techniques already are powerful investigative tools, but with continued improvements in technology, they hold promise of becoming important adjuncts in the monitoring of cerebral hemodynamics in perinatal-neonatal critical care units.