Carotid blood-flow velocity changes detected by Doppler ultrasound in determination of brain death in children: a preliminary report

Doppler ultrasonography of the carotid arteries may be a useful technique for helping to determine brain death in children. Doppler ultrasonography is a kind of ultrasound imaging that analyzes the shift in ultrasonic waves. Seventeen children aged one month to five years with severe brain damage underwent Doppler ultrasonography of the carotid arteries. Seven children were diagnosed as being brain dead by multiple clinical criteria including an EEG. Five of these seven had an abnormal Doppler pattern indicative of brain death. No child who was not diagnosed as brain dead displayed this pattern. The two additional children not identified as brain dead with Doppler ultrasonography had the determining EEG several hours later, suggesting that there may have been further deterioration after the Doppler study. Given the consequences of the diagnosis of brain death, Doppler scans should only be performed and interpreted by skilled vascular ultrasound specialists.