Evidence map›Paper›PMID 33006033›Full record

ArticleNeurocritical care2021

Comparison of Pressure Reactivity Index and Mean Velocity Index to Evaluate Cerebrovascular Reactivity During Induced Arterial Blood Pressure Variations in Severe Brain Injury.

Jonas Pochard, Bernard Vigué, Guillaume Dubreuil, Aurore Rodrigues, Adrien Descorps-Déclère, Jacques Duranteau

Abstract read
PubMed Publisher
In one paragraph

Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Observational
  2. Review
  3. Article
  4. Cerebral autoregulation: every step counts.Critical care (London, England) · 2023
    Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jonas PochardDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France. jonas.pochard@gmail.com.ORCID http://orcid.org/0000-0002-7191-1616
Bernard ViguéDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Guillaume DubreuilDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Aurore RodriguesDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Adrien Descorps-DéclèreDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Jacques DuranteauDepartment of Anesthesiology and Critical Care, Bicêtre Hôpitaux Universitaires Paris Sud, Université Paris Saclay, AP-HP, 78 Rue du Général Leclerc, 94275, Le Kremlin Bicêtre, France.
Université Paris-Saclay · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the assessment of cerebral autoregulation by cerebrovascular reactivity indices based on intracranial pressure (Pressure Reactivity Index, PRx) and on transcranial Doppler (Mean Velocity Index, Mx) during controlled variations of arterial blood pressure in severe brain injury. Primary outcome was the agreement between both cerebrovascular reactivity indices measured by the Bland-and-Altman method. Secondary outcomes were the association of cerebrovascular reactivity indices with arterial blood pressure variation, and the comparison of optimal cerebral perfusion pressures determined by both indices.

methodsAll consecutive comatose (Glasgow Coma Scale < 8) patients from the surgical intensive care unit of Bicetre Hospital who had an acute brain injury on computerized tomography and needed vasopressor support were prospectively included. Step-by-step arterial pressure variations using vasopressors were performed to compare PRx and Mx and to calculate optimal cerebral perfusion pressure (CPPopt). MEASUREMENTS AND MAIN

results15 patients were included. Mean difference between both indices measured by Bland-and-Altman plot was - 0.07 (IC 95% [- 1.02 to 0.87]). Mx was significantly associated with arterial pressure variation (one-way ANOVA test, p = 0.007), whereas PRx was not (p = 0.44). Optimal cerebral perfusion pressure calculated with PRx and Mx was respectively 11 and 15mmHg higher than the mean perfusion pressure prescribed. Optimal cerebral perfusion pressure calculation was possible in all cases.

conclusionsCerebral vasoreactivity indices calculated with intracranial pressure or transcranial Doppler show only moderate agreement. Both indices nonetheless suggest substantially higher optimal cerebral perfusion pressure than those currently provided by international guidelines.

Indexed as

Arterial PressureBrain InjuriesBlood PressureCerebrovascular CirculationHumansIntracranial PressureUltrasonography, Doppler, TranscranialCerebral blood flowCerebral vasoreactivityIntracranial pressureNeurocritical careTranscranial Doppler

Identifiers

PMID33006033
OpenAlexW3089886085

What OpenQuestion holds

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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.