Application of robotic transcranial Doppler for extended duration recording in moderate/severe traumatic brain injury: first experiences

Abstract

Long duration application of transcranial Doppler (TCD) for recording of middle cerebral artery (MCA) cerebral blood flow velocity (CBFV) has been fraught with difficulties.[1,2] Classically, TCD has been labor intensive, with limited ability to obtain uninterrupted recordings for extended periods. Furthermore, application of TCD within neurocritically ill for long durations has been limited given the complexity of care, regular bedside nursing care/patient manipulations, and presence of various other multi-modal monitoring devices. This is especially the case in traumatic brain injury (TBI) patients, with the adoption of extensive multi-modal monitoring. Within TBI, most TCD recordings, using standard widely available probes and holders, range from 30 minutes to 1-hour duration and are frequently interrupted due to shifting of the probe and signal loss.[3,4] Thus, we are typically left with a “snap-shot” recording with TCD examination, limiting our ability to extract valuable continuous variables, such as autoregulatory capacity.[3-5] Recent advances in robotics have led