{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:01:55Z","timestamp":1782860515463,"version":"3.54.5"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Transcranial Doppler ultrasound is a sensitive, real time tool used for monitoring cerebral blood flow; it could provide additional information for cerebral perfusion in cerebral resuscitation during post cardiac arrest care. The aim of the current study was to evaluate the utility of a point-of-care transcranial Doppler ultrasound management algorithm on outcomes in pediatric asphyxial out-of-hospital cardiac arrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study was conducted in two tertiary pediatric intensive care units between January 2013 and June 2018. All children between 1 month and 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions, who were treated with therapeutic hypothermia and survived for 12 h or more after the return of circulation were eligible for inclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-one patients met the eligibility criteria for the study. Sixteen (76.2%) of the 21 children were male, and the mean age was 2.8 \u00b1 4.1 years. Seven (33.3%) of the children had underlying disorders. The overall 1-month survival rate was 52.4%. Twelve (57.1%) of the children received point-of-care transcranial Doppler ultrasound. The 1-month survival rate was significantly higher (<jats:italic>p<\/jats:italic> = 0.03) in the point-of-care transcranial Doppler ultrasound group (9\/12, 75%) than in the non-point-of-care transcranial Doppler ultrasound group (2\/9, 22.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Point-of-care transcranial Doppler ultrasound group was associated with a significantly better 1-month survival rate compared with no point-of-care transcranial Doppler ultrasound group in pediatric asphyxial out-of-hospital cardiac arrest.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2021.690405","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T09:33:12Z","timestamp":1643362392000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Utility of a Point-of-Care Transcranial Doppler Ultrasound Management Algorithm on Outcomes in Pediatric Asphyxial Out-of-Hospital Cardiac Arrest \u2013 An Exploratory Investigation"],"prefix":"10.3389","volume":"8","author":[{"given":"Jainn-Jim","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan-Chang","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Hsuan","family":"Hsia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Jui","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huei-Shyong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Hsin","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chou","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oi-Wa","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"En-Pei","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuang-Lin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.pediatrneurol.2012.12.021","article-title":"Therapeutic hypothermia associated with increased survival after resuscitation in children","volume":"48","author":"Lin","year":"2013","journal-title":"Pediatr Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.resuscitation.2018.08.019","article-title":"72-h therapeutic hypothermia improves neurological outcomes in paediatric asphyxial out-of-hospital cardiac arrest-An exploratory investigation","volume":"133","author":"Lin","year":"2018","journal-title":"Resuscitation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.resuscitation.2018.02.008","article-title":"24 vs. 72 hours of hypothermia for pediatric cardiac arrest: A pilot, randomized controlled trial","volume":"126","author":"Fink","year":"2018","journal-title":"Resuscitation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1161\/CIRCULATIONAHA.113.002408","article-title":"Duration of resuscitation efforts and functional outcome after out-of-hospital cardiac arrest: when should we change to novel therapies","volume":"128","author":"Reynolds","year":"2013","journal-title":"Circulation."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1056\/NEJM199611143352001","article-title":"Outcome of out-of-hospital cardiac or respiratory arrest in children","volume":"335","author":"Schindler","year":"1996","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1007\/BF01720676","article-title":"Prognostic significance of early intracranial and cerebral perfusion pressures in post-cardiac arrest anoxic coma","volume":"17","author":"Gueugniaud","year":"1991","journal-title":"Intensive Care Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/00003246-199907000-00026","article-title":"Effect of arrest time and cerebral perfusion pressure during cardiopulmonary resuscitation on cerebral blood flow, metabolism, adenosine triphosphate recovery, and pH in dogs","volume":"27","author":"Shaffner","year":"1999","journal-title":"Crit Care Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1161\/01.STR.32.1.128","article-title":"Autoregulation of cerebral blood flow in patients resuscitated from cardiac arrest","volume":"32","author":"Sundgreen","year":"2001","journal-title":"Stroke."},{"key":"B9","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1002\/jnr.24148","article-title":"Transcranial Doppler: a stethoscope for the brain-neurocritical care use","volume":"96","author":"Robba","year":"2018","journal-title":"J Neurosci Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.resuscitation.2015.01.029","article-title":"Transcranial Doppler ultrasound in therapeutic hypothermia for children after resuscitation","volume":"89","author":"Lin","year":"2015","journal-title":"Resuscitation."},{"key":"B11","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.surneu.2003.12.007","article-title":"Transcranial Doppler sonography pulsatility index (PI) reflects intracranial pressure (ICP)","volume":"62","author":"Bellner","year":"2004","journal-title":"Surg Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13089-017-0077-9","article-title":"Point-of-care transcranial Doppler by intensivists","volume":"9","author":"Lau","year":"2017","journal-title":"Crit Ultrasound J."},{"key":"B13","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/0883-9441(94)90013-2","article-title":"A noninvasive method for monitoring cerebral perfusion during cardiopulmonary resuscitation","volume":"9","author":"Lewis","year":"1994","journal-title":"J Crit Care."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1016\/j.resuscitation.2009.07.011","article-title":"Use of transcranial Doppler ultrasound in the management of post-cardiac arrest syndrome","volume":"80","author":"Alvarez-Fern\u00e1ndez","year":"2009","journal-title":"Resuscitation."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1097\/CCM.0b013e3181ce495b","article-title":"Transcranial Doppler ultrasound in therapeutic hypothermia for cardiac arrest survivors","volume":"38","author":"Alvarez-Fern\u00e1ndez","year":"2010","journal-title":"Crit Care Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/0300-9572(90)90004-X","article-title":"A comparison of transcranial Doppler ultrasound (TCD) and radioactive microspheres in determining cerebral perfusion in normal and low flow states","volume":"20","author":"Lewis","year":"1990","journal-title":"Resuscitation."},{"key":"B17","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s12028-011-9649-x","article-title":"Hyperosmolar therapy for intracranial hypertension","volume":"17","author":"Torre-Healy","year":"2012","journal-title":"Neurocrit Care."},{"key":"B18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1097\/MCC.0b013e32835eba30","article-title":"New trends in hyperosmolar therapy?","volume":"19","author":"Diringer","year":"2013","journal-title":"Curr Opin Crit Care."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1097\/00003246-200004000-00037","article-title":"Prolonged hypernatremia controls elevated intracranial pressure in head-injured pediatric patients","volume":"28","author":"Peterson","year":"2000","journal-title":"Crit Care Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1097\/PCC.0b013e318291772b","article-title":"Complications associated with prolonged hypertonic saline therapy in children with elevated intracranial pressure","volume":"14","author":"Gonda","year":"2013","journal-title":"Pediatr Crit Care Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1159\/000322083","article-title":"Use and effect of vasopressors after pediatric traumatic brain injury","volume":"32","author":"Di Gennaro","year":"2010","journal-title":"Dev Neurosci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0022-510X(98)00158-0","article-title":"Consensus opinion on diagnosis of cerebral circulatory arrest using Doppler-sonography: The Task Force Group on Cerebral Death of the Neurosonology Research Group of the World Federation of Neurology","volume":"159","author":"Ducrocq","year":"1998","journal-title":"J Neurol Sci."},{"key":"B23","first-page":"247","article-title":"Transcranial Doppler assessment of brain death in children","volume":"39","author":"Qian","year":"1998","journal-title":"Singapore Med J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1111\/j.1552-6569.2003.tb00157.x","article-title":"Outcome in children with significantly abnormal cerebral blood flow detected by Doppler ultrasonography: focus on the survivors","volume":"13","author":"Chiu","year":"2003","journal-title":"J Neuroimaging."},{"key":"B25","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1097\/PCC.0000000000001737","article-title":"Management of pediatric severe traumatic brain injury: 2019 consensus and guidelines-based algorithm for first and second tier therapies","volume":"20","author":"Kochanek","year":"2019","journal-title":"Pediatr Crit Care Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.resuscitation.2018.02.005","article-title":"Cerebral blood flow velocity and autoregulation in paediatric patients following a global hypoxic-ischaemic insult","volume":"126","author":"Lovett","year":"2018","journal-title":"Resuscitation."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.690405\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T09:33:15Z","timestamp":1643362395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.690405\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,28]]},"references-count":26,"alternative-id":["10.3389\/fmed.2021.690405"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.690405","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,28]]},"article-number":"690405"}}