Practice Recommendations for Transcranial Doppler Ultrasonography in Critically Ill Children in the Pediatric Intensive Care Unit: A Multidisciplinary Expert Consensus Statement

Abstract

Transcranial Doppler ultrasonography (TCD) is being used in many pediatric intensive care units (PICUs) to aid in the diagnosis and monitoring of children with known or suspected pathophysiological changes to cerebral hemodynamics. Standardized approaches to scanning protocols, interpretation, and documentation of TCD examinations in this setting are lacking. A panel of multidisciplinary clinicians with expertise in the use of TCD in the PICU undertook a three-round modified Delphi process to reach unanimous agreement on 34 statements and then create practice recommendations for TCD use in the PICU. Use of these recommendations will help to ensure that high quality TCD images are captured, interpreted, and reported using standard nomenclature. Furthermore, use will aid in ensuring reproducible and meaningful study results between TCD practitioners and across PICUs.

Keywords: pediatric critical care; pediatric intensive care unit; practice recommendations; protocol; transcranial doppler ultrasound.

Conflict of interest statement

Conflict of Interest K.L.L. has a patent emboli detection method to identify mechanisms of brain injury in susceptible adults and children pending. Rest authors declare no conflict of interest.

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Figures

Fig. 1

Modified Delphi methodology and results.

Fig. 2

(A,B) Example template for reporting of TCD results in the PICU. Printable and modifiable version available at: http://www.pncrg.org . PICU, pediatric intensive care units; TCD, transcranial Doppler ultrasonography.