Observational studyJournal of neurosurgical anesthesiology2020
Near-infrared Spectroscopy-derived Cerebral Autoregulation Indices Independently Predict Clinical Outcome in Acutely Ill Comatose Patients.
Observational study in Journal of neurosurgical anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- Association of deranged cerebrovascular reactivity with brain injury following cardiac arrest: a post-hoc analysis of the COMACARE trial.Critical care (London, England) · 2021Trial
- Non-invasive cerebral oxygenation and blood pressure neuromonitoring characterizes dynamic cerebrovascular autoregulation following cardiac arrest.Resuscitation plus · 2026Article
- On the utility of near-infrared spectroscopy-derived measures for assessing cerebrovascular autoregulation: results from an observational cohort study.Journal of clinical monitoring and computing · 2026Observational
- The Impact of Near-Infrared Spectroscopy in Early Detection of Cerebral Deterioration After Aneurysmal Subarachnoid Haemorrhage.Journal of clinical medicine · 2026Article
- Intercerebral autoregulation index consistency in the derivation of CPPopt, MAPopt, and BISopt in humans: A scoping review.Physiological reports · 2025Article
- The Relationship Between Pressure Reactivity and Cerebral Oximetry Indexes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Single-Center Pilot Study.Neurocritical care · 2025Article
- Cerebral autoregulation, spreading depolarization, and implications for targeted therapy in brain injury and ischemia.Reviews in the neurosciences · 2024Review
- Dynamic cerebral blood flow assessment based on electromagnetic coupling sensing and image feature analysis.Frontiers in bioengineering and biotechnology · 2024Article
- Multimodal monitoring: practical recommendations (dos and don'ts) in challenging situations and uncertainty.Frontiers in neurology · 2023Review
- Integrative physiological assessment of cerebral hemodynamics and metabolism in acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022Review
- Monitoring and modifying brain oxygenation in patients at risk of hypoxic ischaemic brain injury after cardiac arrest.Critical care (London, England) · 2021Review
- Near-Infrared Spectroscopy Assessments of Regional Cerebral Oxygen Saturation for the Prediction of Clinical Outcomes in Patients With Cardiac Arrest: A Review of Clinical Impact, Evolution, and Future Directions.Frontiers in medicine · 2020Review
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveOutcome prediction in comatose patients with acute brain injury remains challenging. Regional cerebral oxygenation (rSO2) derived from near-infrared spectroscopy (NIRS) is a surrogate for cerebral blood flow and can be used to calculate cerebral autoregulation (CA) continuously at the bedside from the derived cerebral oximetry index (COx). We hypothesized that COx derived thresholds for CA are associated with outcomes in patients with acute coma from neurological injury.
methodsA prospective cohort study was conducted in 88 acutely comatose adults with heterogenous brain injury diagnoses who were continuously monitored with COx for up to 3 consecutive days. Multivariable logistic regression was performed to investigate association between averaged COx and short (in-hospital and 3 mo) and long-term (6 mo) outcomes.
resultsSix month mortality rate was 62%. Median COx in nonsurvivors at hospital discharge was 0.082 [interquartile range, IQR: 0.045 to 0.160] compared with 0.042 [IQR: -0.005 to 0.110] in survivors (P=0.012). At 6 months, median COx was 0.075 [IQR: 0.27 to 0.158] in nonsurvivors compared with 0.029 [IQR: -0.015 to 0.077] in survivors (P=0.02). In the multivariable logistic regression model adjusted for confounders, average COx ≥0.05 was associated with both in-hospital mortality (adjusted odds ratio [OR]=2.9, 95% confidence interval [CI]=1.15-7.33, P=0.02), mortality at 6 months (adjusted OR=4.4, 95% CI=1.41-13.7, P=0.01), and severe disability (modified Rankin Score ≥4) at 6 months (adjusted OR=4.4, 95% CI=1.07-17.8, P=0.04). Area under the receiver operating characteristic curve for predicting mortality and severe disability at 6 months were 0.783 and 0.825, respectively.
conclusionsAveraged COx ≥0.05 is independently associated with short and long-term mortality and long-term severe disability in acutely comatose adults with neurological injury. We propose that COx ≥0.05 represents an accurate threshold to predict long-term functional outcome in acutely comatose adults.
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