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Updated: Apr 25, 2026
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Observational Examination of Cerebral Perfusion Changes in Patients Diagnosed with Sepsis Using Transcranial Doppler
Payam Rahimi1, Remzi Işçimen2, Pınar Küçükdemirci Kaya2
1Department of Anesthesiology and Reanimation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Background:
Sepsis-associated Brain Dysfunction (SABD) affects over 70% of septic patients, often manifesting early and increasing the risk of neurological sequelae if undiagnosed. Transcranial Doppler (TCD) ultrasonography is a noninvasive, bedside method to assess Cerebral Blood Flow (CBF). This study evaluates temporal changes in middle cerebral artery blood flow in septic patients using Pulsatility Index (PI), Resistance Index (RI), and CBFi at 0, 6, 24, and 48 hours.
Materials And Methods:
Forty-seven septic patients admitted to the Bursa Uludag University Intensive Care Unit were prospectively studied. Demographic data, comorbidities, Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II scores, vital signs, laboratory parameters, and TCD measurements (PI, RI, CBFi) were recorded at baseline, 6, 24, and 48 hours.
Results:
No statistically significant changes were observed in PI, RI, or CBFi at 6, 24, or 48 hours compared to baseline (p>0.05), though slight increases in PI (2.13%) and CBFi (16.99%) were noted at 48 hours. A significant difference in PI was found at 48 hours in patients receiving vasoactive drugs (p<0.05), and in RI at 6 hours in those receiving sedoanalgesics (p<0.05). Stable systemic hemodynamics were maintained using advanced monitoring.
Conclusion:
In septic patients with optimized hemodynamic management, cerebrovascular resistance and perfusion indices (PI, RI, CBFi) remain largely stable within 48 hours, suggesting effective autoregulation. TCD shows potential as a tool to monitor cerebral perfusion and guide therapy in sepsis, warranting further research.
