Evidence map›Paper›PMID 28244000›Full record

ArticleNeurocritical care2017

Changes in Cerebral Perfusion with Induced Hypertension in Aneurysmal Subarachnoid Hemorrhage: A Pilot and Feasibility Study.

Amanda Murphy, Airton Leonardo de Oliveira Manoel, R Loch Macdonald, Andrew Baker, Ting-Yim Lee, Tom Marotta, Walter Montanera, Richard Aviv, Aditya Bharatha

Abstract read
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. CTP and DCI: We Need Clarification.Neurocritical care · 2017
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Amanda MurphyDepartment of Medical Imaging, University of Toronto, 30 Bond Street, Room 3-077CC, Toronto, ON, M5B 1W8, Canada. amanda.murphy@mail.utoronto.ca.ORCID http://orcid.org/0000-0002-1792-8847
Airton Leonardo de Oliveira ManoelSt. Michael's Hospital, Toronto, ON, Canada.
R Loch MacdonaldDepartment of Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada.
Andrew BakerDepartment of Critical Care, St. Michael's Hospital, Toronto, ON, Canada.
Ting-Yim LeeRobarts Research Institute, London, ON, Canada.
Tom MarottaDepartment of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada.
Walter MontaneraDepartment of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada.
Richard AvivDepartment of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Aditya BharathaDepartment of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada.
St. Michael's Hospital · CARobarts Clinical Trials · CASunnybrook Health Science Centre · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with computed tomography perfusion (CTP) before and after IH; (2) evaluate differences in the presence of infarction and clinical outcome between patients with and without IH.

methodsWe performed a retrospective cohort analysis of 25 aneurysmal SAH patients. IH was initiated as per the standard institutional protocol when patients showed clinical symptoms of delayed cerebral ischemia (DCI). Differences in CBF, CBV, and MTT between early (<72 h after aneurysm rupture) and late (7-10 days after aneurysm rupture) CTP were quantified in patients with (n = 13) and without IH (n = 12). Outcome measures included cerebral infarction and clinical outcome at 3 months.

resultsEarly MTT was significantly greater in the IH group compared to the no-IH group. There was no difference in early or late CBV or CBF between the two groups. In patients that received IH, there was a significant decrease in MTT between the early (7.0 ± 1.2 s) and late scans (5.8 ± 1.6 s; p = 0.005). There was no difference in the incidence of infarction (5/13 vs. 2/11) or poor outcome (3/11 vs. 6/13) between the IH and no-IH groups, respectively (p > 0.05).

conclusionsElevated MTT is a significant factor for the development of DCI in patients eventually requiring IH therapy and is improved by IH treatment. Therapies to prevent DCI and improve clinical outcome may need to be initiated earlier, when cerebral perfusion abnormalities are first identified.

Indexed as

AgedBrain IschemiaCerebral AngiographyCerebral Blood VolumeCerebrovascular CirculationComputed Tomography AngiographyFeasibility StudiesFemaleHumansHypertensionIntracranial AneurysmMaleMiddle AgedPilot ProjectsRetrospective StudiesSubarachnoid HemorrhageCT perfusionInduced hypertensionSubarachnoid hemorrhage

Identifiers

PMID28244000
OpenAlexW2594190663

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.