Observational studyCritical care (London, England)2019
Quantitative pupillometry for the monitoring of intracranial hypertension in patients with severe traumatic brain injury.
Observational study in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 78 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.
Outcome pRognostication of Acute Brain Injury With the NeuroloGical Pupil
Constructing a Model of Pupillary Parameters in Predicting Delirium Among Critically Ill Patients in the Intensive Unit
Who cites it
78 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of automated pupillometry in traumatic brain injury: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients.Journal of clinical monitoring and computing · 2023Trial
- Resting pupil size is a predictor of hypotension after induction of general anesthesia.Journal of anesthesia · 2019Trial
- Comparison of two automated pupillometry indices in patients with acute brain injury: the prospective multicentre LYNX cohort study.Critical care (London, England) · 2026Observational
- From Neurological Severity to Anatomical Burden: An Integrated Clinical-CT Model for Predicting In-Hospital Mortality in Adults with Penetrating Cranial Gunshot Injuries.Diagnostics (Basel, Switzerland) · 2026Article
- Non-invasive intracranial pressure estimation in the intensive care unit: narrative review of methods and clinical applications.Intensive care medicine · 2026Review
- Quantitative pupillometry as a sensitive tool for detecting hydrocephalus-related physiologic burden after aSAH: a prospective feasibility study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Predictive Accuracy of Glasgow Coma Scale and Pupillary Data on Presence of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
- Persistence of NPi differential predicts outcome at intensive care unit discharge: a single-center retrospective analysis.Journal of anesthesia, analgesia and critical care · 2026Article
- Favourable outcome in a subset of ultra-severe traumatic brain injury patients - a single-centre retrospective study.Brain & spine · 2026Article
- The association between neurologic pupillary index (NPi) and functional outcomes in critically ill children.BMC pediatrics · 2025Observational
- Quantitative pupillometry as a sensitive tool for detecting tumor-related mass effect in the posterior fossa: a prospective feasibility study comparing metastatic versus skull base lesions.Journal of neuro-oncology · 2025Article
- Dangerous Alarming Diameter Assessment (DADA Index) in Which the Ratio of Iris Surface/Pupil Surface Size Is More Reliable than Pupil Diameter Measurement in Comatose Patients After Subarachnoid Haemorrhage: An Experimental Rabbit Model.Diagnostics (Basel, Switzerland) · 2025Article
- Quantitative pupillometry as a sensitive biomarker for detecting subtle neurological impairment in mild traumatic brain injury - a pilot study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Article
- Early Pupil Abnormality Frequency Predicts Poor Outcomes and Enhances International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Model Prognostication in Traumatic Brain Injury.Critical care explorations · 2025Observational
- Sedatives in neurocritical care: the old, the new, the future.Intensive care medicine · 2025Article
- Prognostic role of quantitative pupillometry in traumatic brain injury: a scoping review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Neurological Pupil Index and Intracranial Hypertension in Patients With Acute Brain Injury: A Secondary Analysis of the ORANGE Study.JAMA neurology · 2025Observational
- Invasive and non-invasive monitoring in the ICU.Trauma surgery & acute care open · 2025Review
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated intracranial pressure (ICP) is frequent after traumatic brain injury (TBI) and may cause abnormal pupillary reactivity, which in turn is associated with a worse prognosis. Using automated infrared pupillometry, we examined the relationship between the Neurological Pupil index (NPi) and invasive ICP in patients with severe TBI.
methodsThis was an observational cohort of consecutive subjects with severe TBI (Glasgow Coma Scale [GCS] < 9 with abnormal lesions on head CT) who underwent parenchymal ICP monitoring and repeated NPi assessment with the NPi-200® pupillometer. We examined NPi trends over time (four consecutive measurements over intervals of 6 h) prior to sustained elevated ICP > 20 mmHg. We further analyzed the relationship of cumulative abnormal NPi burden (%NPi values < 3 during total ICP monitoring time) with intracranial hypertension (ICHT)-categorized as refractory (ICHT-r; requiring surgical decompression) vs. non-refractory (ICHT-nr; responsive to medical therapy)-and with the 6-month Glasgow Outcome Score (GOS).
resultsA total of 54 patients were studied (mean age 54 ± 21 years, 74% with focal injuries on CT), of whom 32 (59%) had ICHT. Among subjects with ICHT, episodes of sustained elevated ICP (n = 43, 172 matched ICP-NPi samples; baseline ICP [T
conclusionsIn a selected cohort of severe TBI patients with abnormal head CT lesions and predominantly focal cerebral injury, elevated ICP episodes correlated with a concomitant decrease of NPi. Sustained abnormal NPi was in turn associated with a more complicated ICP course and worse outcome.
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Registered trials
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.