Evidence map›Paper›PMID 31102237›Full record

Observational studyNeurocritical care2019

Early Transcranial Doppler Evaluation of Cerebral Autoregulation Independently Predicts Functional Outcome After Aneurysmal Subarachnoid Hemorrhage.

Carla B Rynkowski, Airton Leonardo de Oliveira Manoel, Marcelo Martins Dos Reis, Corina Puppo, Paulo Valdeci Worm, Diego Zambonin, Marino Muxfeldt Bianchin

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurocritical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% 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

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Observational
  4. Brain-kidney crosstalk in subarachnoid hemorrhage patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. POCUS, how can we include the brain? An overview.Journal of anesthesia, analgesia and critical care · 2022
    Review
  11. Article
  12. Article
  13. Review
  14. Review
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  16. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

Carla B RynkowskiGraduate Program in Medical Science, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. carlarynkowski@gmail.com.ORCID http://orcid.org/0000-0002-6946-2751
Airton Leonardo de Oliveira ManoelCritical Care Unit, Hospital Paulistano, UnitedHealth Group Brazil, São Paulo, SP, Brazil.
Marcelo Martins Dos ReisDepartment of Neurosurgery, Hospital Cristo Redentor, Porto Alegre, Rio Grande do Sul, Brazil.
Corina PuppoHospital de Clínicas Dr. Manuel Quintela, Universidad de la Republica, Montevideo, Uruguay.
Paulo Valdeci WormDepartment of Neurosurgery, Hospital Cristo Redentor, Porto Alegre, Rio Grande do Sul, Brazil.
Diego ZamboninDepartment of Neurosurgery, Hospital Cristo Redentor, Porto Alegre, Rio Grande do Sul, Brazil.
Marino Muxfeldt BianchinGraduate Program in Medical Science, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Faculdade Redentor · BRUniversidade Federal do Rio Grande do Sul · BRSt. Michael's Hospital · CAUniversidad de la República de Uruguay · UY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCerebral autoregulation (CA) impairment after aneurysmal subarachnoid hemorrhage (SAH) has been associated with delayed cerebral ischemia and an unfavorable outcome. We investigated whether the early transient hyperemic response test (THRT), a transcranial Doppler (TCD)-based CA evaluation method, can predict functional outcome 6 months after aneurysmal SAH.

methodsThis is a prospective observational study of all aneurysmal SAH patients consecutively admitted to a single center between January 2016 and February 2017. CA was evaluated within 72 h of hemorrhage by THRT, which describes the changes in cerebral blood flow velocity after a brief compression of the ipsilateral common carotid artery. CA was considered to be preserved when an increase ≥ 9% of baseline systolic velocity was present. According to the modified Rankin Scale (mRS: 4-6), the primary outcome was unfavorable 6 months after hemorrhage. Secondary outcomes included cerebral infarction, vasospasm on TCD, and an unfavorable outcome at hospital discharge.

resultsForty patients were included (mean age = 54 ± 12 years, 70% females). CA was impaired in 19 patients (47.5%) and preserved in 21 (52.5%). Impaired CA patients were older (59 ± 13 vs. 50 ± 9, p = 0.012), showed worse neurological conditions (Hunt&Hess 4 or 5-47.4% vs. 9.5%, p = 0.012), and clinical initial condition (APACHE II physiological score-12 [5.57-13] vs. 3.5 [3-5], p = 0.001). Fourteen patients in the impaired CA group and one patient in the preserved CA group progressed to an unfavorable outcome (73.7% vs. 4.7%, p = 0.0001). The impaired CA group more frequently developed cerebral infarction than the preserved CA group (36.8% vs. 0%, p = 0.003, respectively). After multivariate analysis, impaired CA (OR 5.15 95% CI 1.43-51.99, p = 0.033) and the APACHE II physiological score (OR 1.67, 95% CI 1.01-2.76, p = 0.046) were independently associated with an unfavorable outcome.

conclusionsEarly CA impairment detected by TCD and admission APACHE II physiological score independently predicted an unfavorable outcome after SAH.

Indexed as

Blood Flow VelocityCerebrovascular CirculationAdultAgedAPACHEBrain IschemiaCerebral InfarctionFemaleHomeostasisHospital Distribution SystemsHumansHyperemiaLogistic ModelsMagnetic Resonance ImagingMaleMiddle AgedCerebral autoregulationCerebral circulationSubarachnoid hemorrhageTranscranial DopplerTransient hyperemic response test

Identifiers

PMID31102237
OpenAlexW2946204057

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.