Trial reportNeurocritical care2012
Continuous cerebral blood flow autoregulation monitoring in patients undergoing liver transplantation.
Trial report in Neurocritical care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- What is the optimal anesthetic monitoring regarding immediate and short-term outcomes after liver transplantation?-A systematic review of the literature and expert panel recommendations.Clinical transplantation · 2022Pooled it
- Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review.Frontiers in neurology · 2021Pooled it
- Compliance-mediated pressure-independent cerebrovascular regulation: a distinct novel mechanism in youth.Biomedical engineering online · 2026Article
- Monitoring of cerebral autoregulation during major surgery in adults, including cardiac surgery: mechanisms, anesthetic impacts, and clinical applications.Frontiers in medicine · 2026Review
- Individualized mean arterial pressure targets in critically ill patients guided by non-invasive cerebral-autoregulation: a scoping review.Critical care (London, England) · 2025Article
- Liver transplant and impact on cerebral autoregulation: a systematic scoping review.Frontiers in transplantation · 2025Review
- Diagnosis and management of pediatric acute liver failure: consensus recommendations of the Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ISPGHAN).Hepatology international · 2024Review
- Observational
- Prospective Pilot Clinical Study of Noninvasive Cerebrovascular Autoregulation Monitoring in Open-Angle Glaucoma Patients and Healthy Subjects.Translational vision science & technology · 2022Article
- Usefulness of Cerebral Oximetry in TBI by NIRS.Journal of clinical medicine · 2021Review
- Cerebral edema and liver disease: Classic perspectives and contemporary hypotheses on mechanism.Neuroscience letters · 2020Review
- Dramatic change in cerebral oximetry during liver transplantation.Proceedings (Baylor University. Medical Center) · 2018Article
- Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation-A Prospective Pilot Study.Frontiers in neurology · 2018Article
- Gradient adjustment method for better discriminating correlating and non-correlating regions of physiological signals: application to the partitioning of impaired and intact zones of cerebral autoregulation.Journal of clinical monitoring and computing · 2017Article
- Protocol based invasive intracranial pressure monitoring in acute liver failure: feasibility, safety and impact on management.Critical care (London, England) · 2017Article
- Recent advances in cerebral oximetry. Assessment of cerebral autoregulation with near-infrared spectroscopy: myth or reality?F1000Research · 2017Review
- Data clustering methods for the determination of cerebral autoregulation functionality.Journal of clinical monitoring and computing · 2016Article
- Factors Associated With Major Adverse Cardiovascular Events After Liver Transplantation Among a National Sample.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2016Article
- Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium.Annals of the American Thoracic Society · 2016Article
- [Progress on perioperative monitoring of cerebral blood flow autoregulation].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2015Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundClinical monitoring of cerebral blood flow (CBF) autoregulation in patients undergoing liver transplantation may provide a means for optimizing blood pressure to reduce the risk of brain injury. The purpose of this pilot project is to test the feasibility of autoregulation monitoring with transcranial Doppler (TCD) and near-infrared spectroscopy (NIRS) in patients undergoing liver transplantation and to assess changes that may occur perioperatively.
methodsWe performed a prospective observational study in 9 consecutive patients undergoing orthotopic liver transplantation. Patients were monitored with TCD and NIRS. A continuous Pearson's correlation coefficient was calculated between mean arterial pressure (MAP) and CBF velocity and between MAP and NIRS data, rendering the variables mean velocity index (Mx) and cerebral oximetry index (COx), respectively. Both Mx and COx were averaged and compared during the dissection phase, anhepatic phase, first 30 min of reperfusion, and remaining reperfusion phase. Impaired autoregulation was defined as Mx ≥ 0.4.
resultsAutoregulation was impaired in one patient during all phases of surgery, in two patients during the anhepatic phase, and in one patient during reperfusion. Impaired autoregulation was associated with a MELD score >15 (p = 0.015) and postoperative seizures or stroke (p < 0.0001). Analysis of Mx categorized in 5 mmHg bins revealed that MAP at the lower limit of autoregulation (MAP when Mx increased to ≥ 0.4) ranged between 40 and 85 mmHg. Average Mx and average COx were significantly correlated (p = 0.0029). The relationship between COx and Mx remained when only patients with bilirubin >1.2 mg/dL were evaluated (p = 0.0419). There was no correlation between COx and baseline bilirubin (p = 0.2562) but MELD score and COx were correlated (p = 0.0458). Average COx was higher for patients with a MELD score >15 (p = 0.073) and for patients with a neurologic complication than for patients without neurologic complications (p = 0.0245).
conclusionsThese results suggest that autoregulation is impaired in patients undergoing liver transplantation, even in the absence of acute, fulminant liver failure. Identification of patients at risk for neurologic complications after surgery may allow for prompt neuroprotective interventions, including directed pressure management.
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