ArticleNeurocritical care2020
Neurological Pupil Index as an Indicator of Neurological Worsening in Large Hemispheric Strokes.
Article in Neurocritical care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07024771 (A Study On Association Between Neurological Pupil Index and Clinical Severity of Hypoxic Ischemic Encephalopathy In Neonates Admitted To Neonatal Neurocritical Care Unit), which is not on this map. Cited by 21 papers.
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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.
A Study On Association Between Neurological Pupil Index and Clinical Severity of Hypoxic Ischemic Encephalopathy In Neonates Admitted To Neonatal Neurocritical Care Unit
Who cites it
21 citing papers in PubMed, 40 citations in OpenAlex.
- Pupilometer efficacy in monitoring anxiety in undergraduate medical students during high-fidelity clinical simulation.Scientific reports · 2025Trial
- Automated pupillometry for the prediction of neurologic outcomes in children requiring extracorporeal membrane oxygenation (ECMO).European journal of pediatrics · 2026Observational
- Persistence of NPi differential predicts outcome at intensive care unit discharge: a single-center retrospective analysis.Journal of anesthesia, analgesia and critical care · 2026Article
- Impact of intravenous atropine bolus on eye pupil diameter and autonomic function in patients evaluated for cardioneuroablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Quantitative Pupillometry Predicts Neurologic Deterioration in Patients with Large Middle Cerebral Artery Stroke.Annals of neurology · 2025Observational
- Automated pupillometry is a predictor of outcome of stroke patients: an observational, prospective, cohort study.Brain communications · 2025Article
- Article
- Isolated reversible mydriasis was associated with the use of nebulized ipratropium bromide: a case series using quantitative pupilometer in Korea.Acute and critical care · 2024Article
- Automated Pupillometry Is Able to Discriminate Patients with Acute Stroke from Healthy Subjects: An Observational, Cross-Sectional Study.Brain sciences · 2024Article
- A Review of the Use of Gaze and Pupil Metrics to Assess Mental Workload in Gamified and Simulated Sensorimotor Tasks.Sensors (Basel, Switzerland) · 2024Review
- Prehospital Triage of Intracranial Hemorrhage and Anterior Large-Vessel Occlusion Ischemic Stroke: Value of the Rapid Arterial Occlusion Evaluation.Stroke (Hoboken, N.J.) · 2023Article
- Neurological Pupillary Index (NPi) Measurement Using Pupillometry and Outcomes in Critically Ill Children.Cureus · 2023Article
- Pupillometry in the follow-up of patients undergoing EVT - prediction of space-occupying hemispheric infarction.Journal of neurology · 2023Article
- Neurological Pupillary Index and Disposition at Hospital Discharge following ICU Admission for Acute Brain Injury.Journal of clinical medicine · 2023Article
- Quantitative pupillary light reflex assessment for prognosis of carbon monoxide poisoning.Frontiers in medicine · 2023Article
- Article
- A differential of the left eye and right eye neurological pupil index is associated with discharge modified Rankin scores in neurologically injured patients.BMC neurology · 2022Observational
- Dexmedetomidine and Other Analgosedatives Alter Pupil Characteristics in Critically Ill Patients.Critical care explorations · 2022Article
- Automated Pupillometry for Assessment of Treatment Success in Nonconvulsive Status Epilepticus.Neurocritical care · 2022Observational
- Abnormal neurological pupil index is associated with malignant cerebral edema after mechanical thrombectomy in large vessel occlusion patients.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectiveCerebral herniation due to brain edema is the major cause of neurological worsening in patients suffering large hemispheric strokes. In this study, we investigated whether quantitative pupillary response could help identify the neurological worsening due to brain swelling in patients with large hemispheric strokes.
methodsQuantitative pupillary assessment using an automated pupillometer (NPi-100) was performed between April 2017 and August 2019 for patients suffering large hemispheric strokes. Consecutive pupillary responses were measured every 2 or 4 h as a part of routine clinical care. We compared the mean neurological pupil index (NPi) values, NPi value at the time of neurological deterioration, and percentage change in NPi from the immediate previous value between patients with and without neurological worsening.
resultsIn this study, 2442 quantitative pupillary assessments were performed (n = 30; mean age, 67.9 years; males, 60.0%). Among the included patients, 10 (33.3%) experienced neurological worsening. Patients with neurological worsening had a significantly lower mean value of NPi and a sudden decrease in the NPi value as compared to those without neurological worsening during the whole monitoring period (3.88 ± 0.65 vs. 4.45 ± 0.46, P < 0.001; and 29.5% vs. 11.1%, P = 0.006, respectively). All patients with NPi values below 2.8 showed neurological deterioration.
conclusionsQuantitative monitoring of the pupillary response using an automated pupillometer could be a useful and noninvasive tool for detecting neurological deterioration due to cerebral edema in large hemispheric stroke patients.
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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.