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001-es BibID:	BIBFORM135708
Első szerző:	Siró Péter (neurológus, aneszteziológus, intenzív terápiás szakorvos)
Cím:	Point-of-Care Transcranial Doppler Sonography at the Intensive Care Unit : A Practical Review of the Fundamentals / Siró Péter, Fülesdi Zsófia, Molnár Csilla, Almási Róbert, Csiba László, Fülesdi Béla
Dátum:	2026
ISSN:	2077-0383
Megjegyzések:	Point-of-care ultrasonography (POCUS) has become an integral part of intensive and emergency care. Despite the widespread use and availability of multipurpose ultrasound devices, the regular assessment of intracranial circulatory conditions has not become a part of daily routine in multidisciplinary intensive care units. This brief narrative review aims to summarize the fundamental knowledge about the transcranial Doppler technique and the most significant clinical areas in which the method can provide valuable assistance in daily diagnostic and therapeutic decision-making. The authors searched the PubMed database for reviews, systematic reviews, and meta-analyses using the keywords "transcranial Doppler sonography; critical care; cerebral vasospasm; brain death diagnosis; non-invasive intracranial pressure monitoring". We conclude that TCD is a simple, yet skilled, bedside method for assessing intracranial circulation. In everyday practice, it can be used to support clinical decision-making primarily in the areas of intracranial pressure monitoring, diagnosis and follow-up of cerebral vasospasm, and diagnosis of cerebral circulatory arrest. The study of cerebral hemodynamics should be an integral part of the increasingly widespread bedside ultrasound diagnostics in intensive care.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk transcranial Doppler sonography cerebral blood flow velocity critical care
Megjelenés:	Journal of Clinical Medicine. - 15 : 4 (2026), p. 1-14. -
További szerzők:	Fülesdi Zsófia (1990-) (radiológus) Molnár Csilla (1962-) (aneszteziológus) Almási Róbert Csiba László (1952-) (neurológus, pszichiáter) Fülesdi Béla (1961-) (aneszteziológus)
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001-es BibID:	BIBFORM134097
Első szerző:	Siró Péter (neurológus, aneszteziológus, intenzív terápiás szakorvos)
Cím:	Cerebrovascular Reactivity to Acetazolamide in Stable COPD Patients / Siró Péter, Szabó-Szűcs Regina, Dudás Viktória, Horváth Ildikó, Fülesdi Béla, Vaskó Attila
Dátum:	2025
ISSN:	2077-0383
Megjegyzések:	Background: COPD patients may be prone to cerebral small vessel disease resulting in perivascular white matter lesions and consequent cognitive decline. The pathophysiolog- ical background of these observations is not completely understood. It is hypothesized that COPD may involve systemic vascular dysfunction extending to the brain. The present study aimed to assess whether acetazolamide-induced cerebral vasoreactivity and cere- brovascular reserve capacity are impaired in patients with COPD. Methods: A total of 17 patients with COPD and 20 healthy control subjects underwent transcranial Doppler monitoring before and after IV administration of 15 mg/kgBW acetazolamide for 20 min. Cerebrovascular reactivity (CVR) was defined as a percent increase in blood flow veloc- ity in the middle cerebral artery (MBFV) after acetazolamide. Cerebrovascular reserve capacity (CVRC) was defined as the maximal percent change in MBFV during the entire registration. Results: Administration of acetazolamide resulted in a slight decrease in pH and a mild increase in PaCO2 (both p < 0.001) in COPD patients. Absolute MBFV values were consequently higher, and pulsatility indices were lower in control subjects compared to those measured in patients with COPD. The CVR at different time points after acetazolamide and CVRC did not show any difference between COPD patients and control subjects. Conclusions: In the present study, in normocapnic mild and normocapnic moderate COPD patients, cerebrovascular reactivity is not impaired, indicating that in mild stages, cerebral arteriolar function is preserved. Further studies, using patient selection based on different severity stages of the disease, may show whether alteration of the cere- bral arteriolar function is responsible for the white matter lesions and cognitive decline observed in severe COPD patients.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk COPD cerebral vasoreactivity acetazolamide transcranial Doppler sonography
Megjelenés:	Journal of Clinical Medicine. - 14 : 23 (2025), p. 1-11. -
További szerzők:	Szabó-Szűcs Regina (1988-) (tüdőgyógyász szakorvos) Dudás Viktória Horváth Ildikó (1964-) (tüdőgyógyász) Fülesdi Béla (1961-) (aneszteziológus) Vaskó Attila (1976-) (tüdőgyógyász)
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001-es BibID:	BIBFORM120447
035-os BibID:	(Scopus)85190128657 (WoS)001201644800001
Első szerző:	Szántó Dorottya (aneszteziológus, intenzív terápiás szakorvos)
Cím:	Correlation of Inflammatory Parameters with the Development of Cerebral Vasospasm, Takotsubo Cardiomyopathy, and Functional Outcome after Spontaneous Subarachnoid Hemorrhage / Dorottya Szántó, Péter Luterán, Nikolett Kóti, Péter Siró, Éva Simon, Zsuzsa Jakab, Judit Gál, János Kappelmayer, Béla Fülesdi, Csilla Molnár
Dátum:	2024
ISSN:	2077-0383
Megjegyzések:	Background: The present work aimed to determine whether a relationship exists between inflammatory parameters and the development of vasospasm (VS) and Takotsubo cardiomyopathy (TTC), as well as clinical outcome, in patients suffering from spontaneous subarachnoid hemorrhage (SAH). Methods: In this study, the authors processed the prospectively collected laboratory and clinical data of spontaneous SAH patients admitted to the neurointensive care unit between March 2015 and October 2023. The highest values of neutrophils (NEUpeak), monocytes (MONOpeak), neutrophil-to-lymphocyte ratio (NLRpeak), and CRP (CRPpeak) during the initial 7 days were correlated with the occurrence of VS and TTC, and with the outcome measures at day 30 after onset. Results: Data were collected from 175 SAH patients. Based on ROC analysis, for the development of VS, MONOpeak was the most accurate indicator (AUC: 0.619, optimal cut-off: 1.45 G/L). TTC with severe left ventricular dysfunction (ejection fraction < 40%) was indicated most sensitively by NEUpeak (ROC: 0.763, optimal cut-off: 12.34 G/L). Both for GOS and Barthel Index at day 30, CRPpeak was the best predictor for the outcome (GOS: ROC: 0.846, optimal cut-off: 78.33 mg/L and Barthel Index: ROC: 0.819, optimal cut-off: 78.33 mg/L). Conclusions: Laboratory parameters referring to inflammation during the initial 7 days after SAH correlate with the development of VS and TTC, and thus may predict functional outcome.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk subarachnoid hemorrhage vasospasm delayed cerebral ischemia Takotsubo cardiomyopathy systemic inflammatory response
Megjelenés:	Journal of Clinical Medicine. - 13 : 7 (2024), p. 1-12. -
További szerzők:	Luterán Péter (1991-) (aneszteziológus) Kóti Nikolett (1998-) (orvostanhallgató) Siró Péter (1973-) (neurológus, aneszteziológus, intenzív terápiás szakorvos) Simon Éva (1963-) (aneszteziológus) Jakab Zsuzsa (1982-) (aneszteziológus) Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Kappelmayer János (1960-) (laboratóriumi szakorvos) Fülesdi Béla (1961-) (aneszteziológus) Molnár Csilla (1962-) (aneszteziológus)
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