Regional CBF (rCBF) Thermal Diffusion Probe (TDP)

Local CBF (lCBF) Laser Doppler Flowmetry (LDF)

Transcranial Doppler (TCD)

Basic principle -indicator

Thermal diffusion in a spherical volume around the tip of the probe

Red blood cell movement within the microcirculation beside the probe

Major vascular Doppler effect coupled with two-dimensional ultrasonography

Applicability

Continuous at bedside

Continuous at bedside

Continuous at bedside

Application fields

Intraoperative (to be developed)

ICU

Intraoperative (to be re-evaluated and developed) ICU

Intraoperative ICU

Device

Minimally invasive

(2 - 2.5 cm below the dura)

Minimally invasive

(1cm below the dura)

Non-invasive (main advantage)

Limitations of use

-Measurement and monitoring of rCBF only in the spherical area (1 - 1.5 cm diameter) around the probe tip

-Site-dependent measurement

-Measurement and monitoring of lCBF only in the 1 or 2 mm surrounding the probe tip

-Site-dependent measurement

-Arterial CBF in medium size vessels (MCA > ACA > PCA)

-Not tissue monitoring

-Possible instability of the probe

Cost-investment

-Monitoring

-Probe (single use)

-Monitoring

-Probe (single use)

-Monitoring

-Probe (reusable)

-Fixation system for probes

Technical expertise, management & nursing

Basic Time-consuming

Basic Time-consuming

Advanced

Specific infrastructure for insertion

Special need

(minimally invasive, ICU, or OR)

Probe tunneled or bolted

Special need

(minimal invasive, ICU or OR)

Probe tunnelled or bolted

No need

Ischaemia detection

Local or regional Cortical and subcortical

(following the insertion’s adequacy)

Local Cortical

(following the insertion’s adequacy)

Hemispheric or global

CPP correlation

Vasoreactivity and autoregulation

Vasoreactivity and autoregulation

Variable Vasoreactivity and autoregulation

Numeric values

-Normal: 40 - 70 mL·100−1·min−1

-Normal: 80 mL·100−1·min−1 (temporo-sylvian cortex) and 60 - 65 mL·100−1·min−1 (fronto-latero-dorsal cortex)

-Normal: 30 - 80 mL·100−1·min−1

Following the artery and based on the velocity assessment