Dúplex transcraneal codificado en color en la Unidad de Cuidados Intensivos Pediátricos: serie de casos y revisión bibliográfica

CRITICAL CARE & EMERGENGY MEDICINE VOL. 6

Color-coded transcranial duplex ultrasound in the Pediatric Intensive Care Unit: case series and literature review

Enviar Artículo

www.doi.org/10.58281/ccem.v6i2.11

Patrick Caqui 1, 2, 3 , Omar Heredia 1, 4, 5 , David Pascual Rojas Flores 3, 6 , Luis F. Guerrero-Vega  .

1. Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
2. Departamento de Emergencias y Áreas Críticas. Instituto Nacional de Salud del Niño.
3. Miembro de USPed Latinoamérica.
4. Hospital Edgardo Rebagliati Martins, Lima, Perú.
5. Hospital Nacional Cayetano Heredia, Lima, Perú.
6. Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México.
7. Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.

Abstract

Abstract: Transcranial color-coded duplex sonography (TCCS) is a noninvasive and readily accessible tool that enhances physiologic monitoring in the Pediatric Intensive Care Unit (PICU), particularly in resource-limited settings or when invasive intracranial pressure monitoring is unavailable or contraindicated. Through a literature review and the analysis of a four-case clinical series involving diverse neurologic conditions, this study highlights the utility of TCCS for detecting abnormalities in cerebral blood flow velocities.

The technique proved valuable in supporting timely and precise clinical decision-making by enabling the identification of conditions such as sedative intoxication, intracranial hypertension secondary to arterial thrombosis following traumatic brain injury, decreased cerebral perfusion pressure in neurotrauma, and cerebral circulatory arrest.

In conclusion, TCCS represents a safe and effective bedside modality that may facilitate more accurate assessment and management of critically ill pediatric patients.

Resumen:

El dúplex transcraneal codificado en color (DTCC) es una herramienta no invasiva y accesible que optimiza el monitoreo fisiológico en la Unidad de Cuidados Intensivos Pediátricos (UCIP), siendo especialmente útil en entornos con recursos limitados o con restricciones para el monitoreo invasivo de la presión intracraneal. Mediante una revisión de la literatura y el análisis de una serie de cuatro casos clínicos con diversas lesiones neurológicas, este trabajo expone la utilidad del procedimiento para detectar alteraciones en las velocidades del flujo sanguíneo cerebral. La técnica demostró ser determinante en la toma de decisiones clínicas urgentes y precisas al permitir la identificación de cuadros como intoxicación por sedantes, hipertensión intracraneal secundaria a trombosis arterial post-traumatismo craneocerebral, disminución de la presión de perfusión cerebral en neurotrauma y el diagnóstico de paro circulatorio cerebral. En conclusión, el DTCC se consolida como un método seguro y eficaz que facilita una asistencia médica más precisa en el manejo del paciente crítico pediátrico.

Color-coded transcranial duplex. Pediatrics. Intracranial hypertension. Neuromonitoring.

Patrick Caqui   
Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
Departamento de Emergencias y Áreas Críticas. Instituto Nacional de Salud del Niño.
Miembro de USPed Latinoamérica.

Omar Heredia   
Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
Hospital Edgardo Rebagliati Martins, Lima, Perú.
Hospital Nacional Cayetano Heredia, Lima, Perú.

David Pascual Rojas Flores  
Miembro de USPed Latinoamérica.
Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México.

 Luis F. Guerrero-Vega  
Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.

  1. Abadal JM, Llompart-Pou JA, Homar J, y cols. Applications of transcranial color-coded duplex sonography in monitoring neurocritical patients. Med Intensiva. 2007;31(9):510–517. doi:10.1016/S0210-5691(07)74858-1.
  2. Verlhac S. Transcranial Doppler in children. Pediatr Radiol. 2011;41(Suppl 1):S153–S165. doi:10.1007/s00247-011-2038-y.
  3. Goraj B, Rifkinson-Mann S, Leslie DR, Lansen TA, Kasoff SS, Tenner MS. Correlation of intracranial pressure and transcranial Doppler resistive index after head trauma. AJNR Am J Neuroradiol. 1994;15(7):1333-1339.
  4. Moreno JA, Mesalles E, Gener J, Tomasa A, Ley A, Roca J, y cols. Evaluating the outcome of severe head injury with transcranial Doppler ultrasonography. Neurosurg Focus. 2000;8(1):e8. doi:10.3171/foc.2000.8.1.1702.
  5. Bellner J, Romner B, Reinstrup P, Kristiansson KA, Ryding E, Brandt L. Transcranial Doppler sonography pulsatility index (PI) reflects intracranial pressure (ICP). Surg Neurol. 2004;62(1):45-51; discussion 51. doi:10.1016/j.surneu.2003.12.007.
  6. Vieira F, Cardoso K, Abecasis F, Batista P, Boto L, Quintas S, y cols. Doppler transcraniano na monitorização do traumatismo craniencefálico grave em pediatria. Acta Pediatr Port. 2012;43(6):239–245. doi:10.25754/pjp.2012.1221.
  7. de Riva N, Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, y cols. Transcranial Doppler pulsatility index: what it is and what it isn’t. Neurocrit Care. 2012;17(1):58–66. doi:10.1007/s12028-012-9672-6.

  8. Figaji AA, Zwane E, Fieggen AG, Siesjo P, Peter JC. Transcranial Doppler pulsatility index is not a reliable indicator of intracranial pressure in children with severe traumatic brain injury. Surg Neurol. 2009;72(4):389–394. doi:10.1016/j.surneu.2009.02.012.

     
  9. Bartels E. Transcranial color-coded duplex ultrasonography in routine cerebrovascular diagnostics. Perspect Med. 2012;1(1–12):325–330. doi:10.1016/j.permed.2012.06.001.

  10. O’Brien NF, Reuter-Rice K, Wainwright MS, Kaplan SL, Appavu B, Erklauer JC, y cols. Practice recommendations for transcranial Doppler ultrasonography in critically ill children in the pediatric intensive care unit: a multidisciplinary expert consensus statement. J Pediatr Intensive Care. 2021;10(2):133–142. doi:10.1055/s-0040-1715128.

     
  11. American College of Radiology; Society for Pediatric Radiology; Society of Radiologists in Ultrasound. AIUM practice guideline for the performance of a transcranial Doppler ultrasound examination for adults and children. J Ultrasound Med. 2012;31(9):1489–1500. doi:10.7863/jum.2012.31.9.1489.
  12. Clusmann H, Schaller C, Schramm J. Pupilas fijas y dilatadas después de traumatismo, accidente cerebrovascular y cirugía intracraneal previa: tratamiento y resultados. J Neurol Neurosurg Psychiatry. 2001;71(2):175–181. doi:10.1136/jnnp.71.2.175.
  13. McCarville MB. Comparison of duplex and nonduplex transcranial Doppler ultrasonography. Ultrasound Q. 2008;24(3):167–171. doi:10.1097/RUQ.0b013e3181862b67.
  14. Robba C, Goffi A, Geeraerts T, Cardim D, Via G, Czosnyka M, y cols. Brain ultrasonography: methodology, basic and advanced principles and clinical applications. Intensive Care Med. 2019;45(7):913–927. doi:10.1007/s00134-019-05610-4.
  15. Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, y cols. International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children. Crit Care. 2020;24(1):65. doi:10.1186/s13054-020-2787-9.
  16. Martin PJ, Evans DH, Naylor AR. Measurement of blood flow velocity in the basal cerebral circulation: advantages of transcranial color-coded sonography over conventional transcranial Doppler. J Clin Ultrasound. 1995;23(1):21–26. doi:10.1002/jcu.1870230105.
  17. Bertuetti R, Gritti P, Pelosi P, Robba C. How to use cerebral ultrasound in the ICU. Minerva Anestesiol. 2020;86(3):327–340. doi:10.23736/S0375-9393.19.13852-7.
  18. Klingelhöfer J, Conrad B, Benecke R, Sander D. Intracranial flow patterns at increasing intracranial pressure. Klin Wochenschr. 1987;65(12):542–545. doi:10.1007/BF01727619.
  19. Schmidt EA, Czosnyka M, Gooskens I, Piechnik SK, Matta BF, Whitfield PC, y cols. Estimation of cerebral perfusion pressure using transcranial Doppler ultrasonography. J Neurol Neurosurg Psychiatry. 2001;70(2):198–204. doi:10.1136/jnnp.70.2.198.
  20. O’Brien NF, Maa T, Reuter-Rice K. Noninvasive screening for intracranial hypertension in children with acute severe traumatic brain injury. J Neurosurg Pediatr. 2015;16(4):420–425. doi:10.3171/2015.3.PEDS14521.
  21. Robba C, Picetti E, Vásquez-García S, Abulhasan YB, Ain A, Adeleye AO, y cols. The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in TBI patients (B-ICONIC). Intensive Care Med. 2025;51(1):4–20. doi:10.1007/s00134-024-07756-2.
  22. Muñoz-Sánchez MA, Murillo-Cabezas F, Rivera-Fernández MV, Rincón-Ferrari D, Amaya-Villar R, Flores-Cordero JM, y cols. The effectiveness of a correlation diagram of echographic and haemodynamic brain patterns. Rev Neurol. 2004;38(5):411–416.
  23. Barrientos-Guerra JD, Flores-Silva F, Cantú-Brito C, Chiquete E. Evaluation of cerebral hemodynamics with color-coded duplex sonography: normative values with correction of insonation angles. J Stroke Cerebrovasc Dis. 2020;29(3):104595. doi:10.1016/j.jstrokecerebrovasdis.2019.104595.
  24. Greer DM, Kirschen MP, Lewis A, Gronseth GS, Rae-Grant A, Ashwal S, y cols. Pediatric and adult brain death/death by neurologic criteria consensus guideline. Neurology. 2023;101(24):1112–1132. doi:10.1212/WNL.0000000000207740.
  25. Shemie SD, Wilson LC, Hornby L, Basmaji J, Baker AJ, Bensimon CM, y cols. A brain-based definition of death and criteria for its determination after arrest of circulation or neurologic function in Canada: a 2023 clinical practice guideline. Can J Anaesth. 2023;70(4):483–557. doi:10.1007/s12630-023-02431-4.
  26. Ducrocq X, Hassler W, Moritake K, Newell DW, von Reutern GM, Shiogai T, y cols. Consensus opinion on diagnosis of cerebral circulatory arrest using Doppler sonography. J Neurol Sci. 1998;159(2):145–150. doi:10.1016/S0022-510X(98)00158-0.

  27. Dominguez-Roldan JM, Jimenez-Gonzalez PI, Garcia-Alfaro C, Rivera-Fernandez V, Hernandez-Hazañas F. Diagnosis of brain death by transcranial Doppler sonography: solutions for cases of difficult sonic windows. Transplant Proc. 2004;36(10):2896–2897. doi:10.1016/j.transproceed.2004.10.052.

  28. Tsivgoulis G, Alexandrov AV, Sloan MA. Advances in transcranial Doppler ultrasonography. Curr Neurol Neurosci Rep. 2009;9(1):46–54. doi:10.1007/s11910-009-0008-7.
  29. Moppett IK, Mahajan RP. Transcranial Doppler ultrasonography in anaesthesia and intensive care. Br J Anaesth. 2004;93(5):710–724. doi:10.1093/bja/aeh205.
  30. Escudero D, Otero J, Quindós B, Viña L. Transcranial Doppler ultrasound in the diagnosis of brain death: Is it useful or does it delay the diagnosis? Med Intensiva. 2015;39(4):244–250. doi:10.1016/j.medin.2014.11.005.
[1] CAQUI VILCA PD. Dúplex transcraneal codificado en color en la Unidad de Cuidados Intensivos Pediátricos: serie de casos y revisión bibliográfica. CC&EM [Internet]. [citado 26 de agosto de 2026];6(2). Disponible en: https://criticalcareandemergencymedicine.com/OJS/index.php/inicio/article/view/11
PDF

Licencia

© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .

Licencia Creative Commons CC BY 4.0

The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.

ISSN

2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

Indexación

Patrocinadores

www.doi.org/10.58281/ccem.v6i2.11

Patrick Caqui 1, 2, 3 , Omar Heredia 1, 4, 5 , David Pascual Rojas Flores 3, 6 , Luis F. Guerrero-Vega  .

1. Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
2. Departamento de Emergencias y Áreas Críticas. Instituto Nacional de Salud del Niño.
3. Miembro de USPed Latinoamérica.
4. Hospital Edgardo Rebagliati Martins, Lima, Perú.
5. Hospital Nacional Cayetano Heredia, Lima, Perú.
6. Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México.
7. Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.

Abstract

Abstract: Transcranial color-coded duplex sonography (TCCS) is a noninvasive and readily accessible tool that enhances physiologic monitoring in the Pediatric Intensive Care Unit (PICU), particularly in resource-limited settings or when invasive intracranial pressure monitoring is unavailable or contraindicated. Through a literature review and the analysis of a four-case clinical series involving diverse neurologic conditions, this study highlights the utility of TCCS for detecting abnormalities in cerebral blood flow velocities.

The technique proved valuable in supporting timely and precise clinical decision-making by enabling the identification of conditions such as sedative intoxication, intracranial hypertension secondary to arterial thrombosis following traumatic brain injury, decreased cerebral perfusion pressure in neurotrauma, and cerebral circulatory arrest.

In conclusion, TCCS represents a safe and effective bedside modality that may facilitate more accurate assessment and management of critically ill pediatric patients.

Resumen:

El dúplex transcraneal codificado en color (DTCC) es una herramienta no invasiva y accesible que optimiza el monitoreo fisiológico en la Unidad de Cuidados Intensivos Pediátricos (UCIP), siendo especialmente útil en entornos con recursos limitados o con restricciones para el monitoreo invasivo de la presión intracraneal. Mediante una revisión de la literatura y el análisis de una serie de cuatro casos clínicos con diversas lesiones neurológicas, este trabajo expone la utilidad del procedimiento para detectar alteraciones en las velocidades del flujo sanguíneo cerebral. La técnica demostró ser determinante en la toma de decisiones clínicas urgentes y precisas al permitir la identificación de cuadros como intoxicación por sedantes, hipertensión intracraneal secundaria a trombosis arterial post-traumatismo craneocerebral, disminución de la presión de perfusión cerebral en neurotrauma y el diagnóstico de paro circulatorio cerebral. En conclusión, el DTCC se consolida como un método seguro y eficaz que facilita una asistencia médica más precisa en el manejo del paciente crítico pediátrico.

Color-coded transcranial duplex. Pediatrics. Intracranial hypertension. Neuromonitoring.

Patrick Caqui   
Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
Departamento de Emergencias y Áreas Críticas. Instituto Nacional de Salud del Niño.
Miembro de USPed Latinoamérica.

Omar Heredia   
Unidad de Cuidados Intensivos Neuroquirúrgica del Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
Hospital Edgardo Rebagliati Martins, Lima, Perú.
Hospital Nacional Cayetano Heredia, Lima, Perú.

David Pascual Rojas Flores  
Miembro de USPed Latinoamérica.
Hospital General Regional No. 1 del Instituto Mexicano del Seguro Social, Querétaro, México.

 Luis F. Guerrero-Vega  
Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.

  1. Abadal JM, Llompart-Pou JA, Homar J, y cols. Applications of transcranial color-coded duplex sonography in monitoring neurocritical patients. Med Intensiva. 2007;31(9):510–517. doi:10.1016/S0210-5691(07)74858-1.
  2. Verlhac S. Transcranial Doppler in children. Pediatr Radiol. 2011;41(Suppl 1):S153–S165. doi:10.1007/s00247-011-2038-y.
  3. Goraj B, Rifkinson-Mann S, Leslie DR, Lansen TA, Kasoff SS, Tenner MS. Correlation of intracranial pressure and transcranial Doppler resistive index after head trauma. AJNR Am J Neuroradiol. 1994;15(7):1333-1339.
  4. Moreno JA, Mesalles E, Gener J, Tomasa A, Ley A, Roca J, y cols. Evaluating the outcome of severe head injury with transcranial Doppler ultrasonography. Neurosurg Focus. 2000;8(1):e8. doi:10.3171/foc.2000.8.1.1702.
  5. Bellner J, Romner B, Reinstrup P, Kristiansson KA, Ryding E, Brandt L. Transcranial Doppler sonography pulsatility index (PI) reflects intracranial pressure (ICP). Surg Neurol. 2004;62(1):45-51; discussion 51. doi:10.1016/j.surneu.2003.12.007.
  6. Vieira F, Cardoso K, Abecasis F, Batista P, Boto L, Quintas S, y cols. Doppler transcraniano na monitorização do traumatismo craniencefálico grave em pediatria. Acta Pediatr Port. 2012;43(6):239–245. doi:10.25754/pjp.2012.1221.
  7. de Riva N, Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, y cols. Transcranial Doppler pulsatility index: what it is and what it isn’t. Neurocrit Care. 2012;17(1):58–66. doi:10.1007/s12028-012-9672-6.

  8. Figaji AA, Zwane E, Fieggen AG, Siesjo P, Peter JC. Transcranial Doppler pulsatility index is not a reliable indicator of intracranial pressure in children with severe traumatic brain injury. Surg Neurol. 2009;72(4):389–394. doi:10.1016/j.surneu.2009.02.012.

     
  9. Bartels E. Transcranial color-coded duplex ultrasonography in routine cerebrovascular diagnostics. Perspect Med. 2012;1(1–12):325–330. doi:10.1016/j.permed.2012.06.001.

  10. O’Brien NF, Reuter-Rice K, Wainwright MS, Kaplan SL, Appavu B, Erklauer JC, y cols. Practice recommendations for transcranial Doppler ultrasonography in critically ill children in the pediatric intensive care unit: a multidisciplinary expert consensus statement. J Pediatr Intensive Care. 2021;10(2):133–142. doi:10.1055/s-0040-1715128.

     
  11. American College of Radiology; Society for Pediatric Radiology; Society of Radiologists in Ultrasound. AIUM practice guideline for the performance of a transcranial Doppler ultrasound examination for adults and children. J Ultrasound Med. 2012;31(9):1489–1500. doi:10.7863/jum.2012.31.9.1489.
  12. Clusmann H, Schaller C, Schramm J. Pupilas fijas y dilatadas después de traumatismo, accidente cerebrovascular y cirugía intracraneal previa: tratamiento y resultados. J Neurol Neurosurg Psychiatry. 2001;71(2):175–181. doi:10.1136/jnnp.71.2.175.
  13. McCarville MB. Comparison of duplex and nonduplex transcranial Doppler ultrasonography. Ultrasound Q. 2008;24(3):167–171. doi:10.1097/RUQ.0b013e3181862b67.
  14. Robba C, Goffi A, Geeraerts T, Cardim D, Via G, Czosnyka M, y cols. Brain ultrasonography: methodology, basic and advanced principles and clinical applications. Intensive Care Med. 2019;45(7):913–927. doi:10.1007/s00134-019-05610-4.
  15. Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, y cols. International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children. Crit Care. 2020;24(1):65. doi:10.1186/s13054-020-2787-9.
  16. Martin PJ, Evans DH, Naylor AR. Measurement of blood flow velocity in the basal cerebral circulation: advantages of transcranial color-coded sonography over conventional transcranial Doppler. J Clin Ultrasound. 1995;23(1):21–26. doi:10.1002/jcu.1870230105.
  17. Bertuetti R, Gritti P, Pelosi P, Robba C. How to use cerebral ultrasound in the ICU. Minerva Anestesiol. 2020;86(3):327–340. doi:10.23736/S0375-9393.19.13852-7.
  18. Klingelhöfer J, Conrad B, Benecke R, Sander D. Intracranial flow patterns at increasing intracranial pressure. Klin Wochenschr. 1987;65(12):542–545. doi:10.1007/BF01727619.
  19. Schmidt EA, Czosnyka M, Gooskens I, Piechnik SK, Matta BF, Whitfield PC, y cols. Estimation of cerebral perfusion pressure using transcranial Doppler ultrasonography. J Neurol Neurosurg Psychiatry. 2001;70(2):198–204. doi:10.1136/jnnp.70.2.198.
  20. O’Brien NF, Maa T, Reuter-Rice K. Noninvasive screening for intracranial hypertension in children with acute severe traumatic brain injury. J Neurosurg Pediatr. 2015;16(4):420–425. doi:10.3171/2015.3.PEDS14521.
  21. Robba C, Picetti E, Vásquez-García S, Abulhasan YB, Ain A, Adeleye AO, y cols. The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in TBI patients (B-ICONIC). Intensive Care Med. 2025;51(1):4–20. doi:10.1007/s00134-024-07756-2.
  22. Muñoz-Sánchez MA, Murillo-Cabezas F, Rivera-Fernández MV, Rincón-Ferrari D, Amaya-Villar R, Flores-Cordero JM, y cols. The effectiveness of a correlation diagram of echographic and haemodynamic brain patterns. Rev Neurol. 2004;38(5):411–416.
  23. Barrientos-Guerra JD, Flores-Silva F, Cantú-Brito C, Chiquete E. Evaluation of cerebral hemodynamics with color-coded duplex sonography: normative values with correction of insonation angles. J Stroke Cerebrovasc Dis. 2020;29(3):104595. doi:10.1016/j.jstrokecerebrovasdis.2019.104595.
  24. Greer DM, Kirschen MP, Lewis A, Gronseth GS, Rae-Grant A, Ashwal S, y cols. Pediatric and adult brain death/death by neurologic criteria consensus guideline. Neurology. 2023;101(24):1112–1132. doi:10.1212/WNL.0000000000207740.
  25. Shemie SD, Wilson LC, Hornby L, Basmaji J, Baker AJ, Bensimon CM, y cols. A brain-based definition of death and criteria for its determination after arrest of circulation or neurologic function in Canada: a 2023 clinical practice guideline. Can J Anaesth. 2023;70(4):483–557. doi:10.1007/s12630-023-02431-4.
  26. Ducrocq X, Hassler W, Moritake K, Newell DW, von Reutern GM, Shiogai T, y cols. Consensus opinion on diagnosis of cerebral circulatory arrest using Doppler sonography. J Neurol Sci. 1998;159(2):145–150. doi:10.1016/S0022-510X(98)00158-0.

  27. Dominguez-Roldan JM, Jimenez-Gonzalez PI, Garcia-Alfaro C, Rivera-Fernandez V, Hernandez-Hazañas F. Diagnosis of brain death by transcranial Doppler sonography: solutions for cases of difficult sonic windows. Transplant Proc. 2004;36(10):2896–2897. doi:10.1016/j.transproceed.2004.10.052.

  28. Tsivgoulis G, Alexandrov AV, Sloan MA. Advances in transcranial Doppler ultrasonography. Curr Neurol Neurosci Rep. 2009;9(1):46–54. doi:10.1007/s11910-009-0008-7.
  29. Moppett IK, Mahajan RP. Transcranial Doppler ultrasonography in anaesthesia and intensive care. Br J Anaesth. 2004;93(5):710–724. doi:10.1093/bja/aeh205.
  30. Escudero D, Otero J, Quindós B, Viña L. Transcranial Doppler ultrasound in the diagnosis of brain death: Is it useful or does it delay the diagnosis? Med Intensiva. 2015;39(4):244–250. doi:10.1016/j.medin.2014.11.005.
[1] CAQUI VILCA PD. Dúplex transcraneal codificado en color en la Unidad de Cuidados Intensivos Pediátricos: serie de casos y revisión bibliográfica. CC&EM [Internet]. [citado 26 de agosto de 2026];6(2). Disponible en: https://criticalcareandemergencymedicine.com/OJS/index.php/inicio/article/view/11
PDF

Licencia

© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .

Licencia Creative Commons CC BY 4.0

The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.

ISSN

2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

Indexación

Patrocinadores

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