ArticleNeurocritical care2015
Normobaric hyperoxia is associated with increased cerebral excitotoxicity after severe traumatic brain injury.
Article in Neurocritical care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02666937 (Safe Limits in Saturation), which is not on this map. Cited by 36 papers, 1 of them a synthesis 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.
Safe Limits in Saturation (SLIM-study)
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- The Impact of Short-Term Hyperoxia on Cerebral Metabolism: A Systematic Review and Meta-Analysis.Neurocritical care · 2022Pooled it
- Hyperoxic cerebral vasoconstriction in healthy humans: global, lobe, and regions of interest.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Article
- Pharmacologic and non-pharmacologic strategies to prevent intracranial pressure surges during endotracheal suctioning in acute brain injury: a narrative review.BMC anesthesiology · 2026Review
- Nutritional Modulation of the Endogenous Antioxidant System in the Brain-Gut Axis Following Traumatic Brain Injury.Nutrients · 2025Article
- Association Between Early Hyperoxemia Exposure and Intensive Care Unit Mortality in Intracerebral Hemorrhage: An Observational Cohort Analysis.Neurocritical care · 2024Observational
- The neuroprotective effects of normobaric oxygen therapy after stroke.CNS neuroscience & therapeutics · 2024Review
- Innovative Insights into Traumatic Brain Injuries: Biomarkers and New Pharmacological Targets.International journal of molecular sciences · 2024Review
- Hyperoxemia after reperfusion in cardiac arrest patients: a potential dose-response association with 30-day survival.Critical care (London, England) · 2023Observational
- Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults with nonhypoxic ischaemic acute brain injuries and conditions in the intensive care unit (Mega-ROX Brains).Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Multimodal and autoregulation monitoring in the neurointensive care unit.Frontiers in neurology · 2023Review
- High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI.Intensive care medicine · 2022Observational
- The effect of targeted hyperoxemia in a randomized controlled trial employing a long-term resuscitated, model of combined acute subdural hematoma and hemorrhagic shock in swine with coronary artery disease: An exploratory, hypothesis-generating study.Frontiers in medicine · 2022Article
- A Precision Medicine Agenda in Traumatic Brain Injury.Frontiers in pharmacology · 2022Review
- Dangers of hyperoxia.Critical care (London, England) · 2021Review
- The Impact of Hyperoxia Treatment on Neurological Outcomes and Mortality in Moderate to Severe Traumatic Brain Injured Patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2021Article
- Microenvironmental Variations After Blood-Brain Barrier Breakdown in Traumatic Brain Injury.Frontiers in molecular neuroscience · 2021Review
- Effect of Early Normobaric Hyperoxia on Blast-Induced Traumatic Brain Injury in Rats.Neurochemical research · 2020Article
- Intra-operative hyperoxia and the risk of delirium in elderly patients after cardiac surgery.Aging · 2020Article
- VENTILatOry strategies in patients with severe traumatic brain injury: the VENTILO Survey of the European Society of Intensive Care Medicine (ESICM).Critical care (London, England) · 2020Article
- Traumatic Brain Injury and Blood-Brain Barrier (BBB): Underlying Pathophysiological Mechanisms and the Influence of Cigarette Smoking as a Premorbid Condition.International journal of molecular sciences · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNormobaric oxygen therapy is frequently applied in neurocritical care, however, whether supplemental FiO2 has beneficial cerebral effects is still controversial. We examined in patients with severe traumatic brain injury (TBI) the effect of incremental FiO2 on cerebral excitotoxicity, quantified by cerebral microdialysis (CMD) glutamate.
methodsThis was a retrospective analysis of a database of severe TBI patients monitored with CMD and brain tissue oxygen (PbtO2). The relationship of FiO2--categorized into four separate ranges (<40, 41-60, 61-80, and >80 %)--with CMD glutamate was examined using ANOVA with Tukey's post hoc test.
resultsA total of 1,130 CMD samples from 36 patients--monitored for a median of 4 days--were examined. After adjusting for brain (PbtO2, intracranial pressure, cerebral perfusion pressure, lactate/pyruvate ratio, Marshall CT score) and systemic (PaCO2, PaO2, hemoglobin, APACHE score) covariates, high FiO2 was associated with a progressive increase in CMD glutamate [8.8 (95 % confidence interval 7.4-10.2) µmol/L at FiO2 < 40 % vs. 12.8 (10.9-14.7) µmol/L at 41-60 % FiO2, 19.3 (15.6-23) µmol/L at 61-80 % FiO2, and 22.6 (16.7-28.5) µmol/L at FiO2 > 80 %; multivariate-adjusted p < 0.05]. The threshold of FiO2-related increase in CMD glutamate was lower for samples with normal versus low PbtO2 < 20 mmHg (FiO2 > 40 % vs. FiO2 > 60 %). Hyperoxia (PaO2 > 150 mmHg) was also associated with increased CMD glutamate (adjusted p < 0.001).
conclusionsIncremental normobaric FiO2 levels were associated with increased cerebral excitotoxicity in patients with severe TBI, independent from PbtO2 and other important cerebral and systemic determinants. These data suggest that supra-normal oxygen may aggravate secondary brain damage after severe TBI.
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