Observational studyNeurocritical care2021
Continuous Monitoring of Cerebral Autoregulation in Children Supported by Extracorporeal Membrane Oxygenation: A Pilot Study.
Observational study in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life Support Organization Consensus Guidelines.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2024Guideline
- Neuromonitoring modalities predicting neurological impairment in pediatric congenital heart disease: a systematic review.Frontiers in neurology · 2024Pooled it
- Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review.Frontiers in neurology · 2021Pooled it
- Impaired Cerebral Autoregulation in Pediatric Patients with ECMO: A Retrospective Analysis of ECMO Time Periods and Association with Neurologic Injury.Neurocritical care · 2026Observational
- How to optimize brain perfusion and prevent cerebral complications during extracorporeal life support.Intensive care medicine · 2026Review
- Novel treatment strategies in cardiogenic shock: an update on ongoing clinical trials.Heart failure reviews · 2026Review
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- Cerebral Autoregulation and Optimal Blood Pressure from Birth to Surgery in Neonates with Critical Congenital Heart Disease.Pediatric cardiology · 2026Observational
- 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
- Autonomic Function and Cerebral Autoregulation in Children Receiving Extracorporeal Life Support.Children (Basel, Switzerland) · 2026Article
- Clinical research study: cerebral autoregulation in neonates and infants undergoing open heart surgery: global patterns and derived cerebral hemodynamic metrics.Pediatric research · 2026Observational
- Death by Neurologic Criteria in Neonates Undergoing Extracorporeal Membrane Oxygenation: Extracorporeal Life Support Organization Registry Study, 2010-2023.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2026Article
- Data pipeline quality: development and validation of a quality assessment tool for data-driven algorithms and artificial intelligence in healthcare.BMJ health & care informatics · 2026Article
- Impaired Cerebral Autoregulation in Children.Pediatric neurology · 2025Review
- Plasma brain-related biomarkers and potential therapeutic targets in pediatric ECMO.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Cerebral Autoregulation: A Target for Improving Neurological Outcomes in Extracorporeal Life Support.Neurocritical care · 2024Review
- Cerebral autoregulation in pediatric and neonatal intensive care: A scoping review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines.Critical care (London, England) · 2024Review
- Neurophysiologic Features Reflecting Brain Injury During Pediatric ECMO Support.Neurocritical care · 2024Observational
- Determining Optimal Mean Arterial Blood Pressure Based on Cerebral Autoregulation in Children after Cardiac Surgery.Pediatric cardiology · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCerebral autoregulation (CA) impairment may pose a risk factor for neurological complications among children supported by extracorporeal membrane oxygenation (ECMO). Our first objective was to investigate the feasibility of CA continuous monitoring during ECMO treatment and to describe its evolution over time. The second objective was to analyze the association between CA impairment and neurological outcome.
designObservational prospective study. PATIENTS AND
settingTwenty-nine children treated with veno-arterial or veno-venous ECMO in the PICU of Nantes University Hospital, France, and the PICU of the IRCCS Giannina Gaslini Institute in Genoa, Italy. MEASUREMENTS: A correlation coefficient between the variations of regional cerebral oxygen saturation and the variations of mean arterial blood pressure (MAP) was calculated as an index of CA (cerebral oxygenation reactivity index, COx). A COx > 0.3 was considered as indicative of autoregulation impairment. COx-MAP plots were investigated allowing determining optimal MAP (MAPopt) and limits of autoregulation: lower (LLA) and upper (ULA). Neurological outcome was assessed by the onset of an acute neurological event (ANE) after ECMO start.
resultsWe included 29 children (median age 84 days, weight 4.8 kg). MAPopt, LLA, and ULA were detected in 90.8% (84.3-93.3) of monitoring time. Mean COx was significantly higher during day 1 of ECMO compared to day 2 [0.1 (0.02-0.15) vs. 0.01 (- 0.05 to 0.1), p = 0.002]. Twelve children experienced ANE (34.5%). The mean COx and the percentage of time spent with a COx > 0.3 were significantly higher among ANE+ compared to ANE- patients [0.09 (0.01-0.23) vs. 0.04 (- 0.02 to 0.06), p = 0.04 and 33.3% (24.8-62.1) vs. 20.8% (17.3-23.7) p = 0.001]. ANE+ patients spent significantly more time with MAP below LLA [17.2% (6.5-32.9) vs. 5.6% (3.6-9.9), p = 0.02] and above ULA [13% (5.3-38.4) vs. 4.2% (2.7-7.4), p = 0.004], respectively.
conclusionCA assessment is feasible in pediatric ECMO. The first 24 h following ECMO represents the most critical period regarding CA. Impaired autoregulation is significantly more severe among patients who experience ANE.
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