Evidence map›Paper›PMID 35100588›Full record

Observational studyDevelopmental neuroscience2022

The Utility of Cerebral Autoregulation Indices in Detecting Severe Brain Injury Varies by Cooling Treatment Phase in Neonates with Hypoxic-Ischemic Encephalopathy.

May W Chen, Jennifer K Lee, Gilbert Vezina, Aylin Tekes, Jamie Perin, Ruoying Li, Alexandra O'Kane, Meaghan McGowan, Taeun Chang, Charlamaine Parkinson and 6 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Developmental neuroscience, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Hemodynamics in infants with hypoxemic ischemic encephalopathy: pathophysiology and beyond.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Review
  2. Article
  3. 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 · 2024
    Article
  4. Review
  5. Observational
  6. Review
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

16 authors.

May W ChenDivision of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jennifer K LeeDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Gilbert VezinaDivision of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, District of Columbia, USA.
Aylin TekesDivision of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jamie PerinDepartment of Pediatrics, Center for Child and Community Health Research, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ruoying LiDivision of Neurology, Children's National Hospital, Washington, District of Columbia, USA.
Alexandra O'KaneDivision of Neurology, Children's National Hospital, Washington, District of Columbia, USA.
Meaghan McGowanDivision of Neurology, Children's National Hospital, Washington, District of Columbia, USA.
Taeun ChangDepartment of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia, USA.
Charlamaine ParkinsonDivision of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Colleen KreinPrenatal Pediatrics Institute, Children's National Hospital, Washington, District of Columbia, USA.
Tareq Al-ShargabiPrenatal Pediatrics Institute, Children's National Hospital, Washington, District of Columbia, USA.
Frances J NorthingtonDivision of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ken M BradyDepartment of Anesthesiology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
An N MassaroDepartment of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia, USA.
Rathinaswamy B GovindanDepartment of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia, USA.

Funding

Proteasome activation to protect the white matter in neonatal hypoxic-ischemic encephalopathy.R01NS113921 · NINDS · JOHNS HOPKINS UNIVERSITY · PI LEE, JENNIFER KIM, MARTIN, LEE J · 2020 to 2023
$2.2M
Brain Microstructural MRI in a Piglet Model of Hypoxia-IschemiaR01NS107417 · NINDS · JOHNS HOPKINS UNIVERSITY · PI LEE, JENNIFER KIM · 2018 to 2022
$1.8M
Cholinergic neuron degeneration after HI: New target for delayed therapy of neonatal HI to improve Learning and Memory DeficitsR21NS123814 · NINDS · JOHNS HOPKINS UNIVERSITY · PI NORTHINGTON, FRANCES J · 2022 to 2023
$450k
NINDS NIH HHS R01 NS107417NINDS NIH HHS R01 NS113921NINDS NIH HHS R21 NS123814
6 · The paper itself

Abstract

Identifying the hemodynamic range that best supports cerebral perfusion using near infrared spectroscopy (NIRS) autoregulation monitoring is a potential physiologic marker for neonatal hypoxic-ischemic encephalopathy (HIE) during therapeutic hypothermia. However, an optimal autoregulation monitoring algorithm has not been identified for neonatal clinical medicine. We tested whether the hemoglobin volume phase (HVP), hemoglobin volume (HVx), and pressure passivity index (PPI) identify changes in autoregulation that are associated with brain injury on MRI or death. The HVP measures the phase difference between a NIRS metric of cerebral blood volume, the total hemoglobin (THb), and mean arterial blood pressure (MAP) at the frequency of maximum coherence. The HVx is the correlation coefficient between MAP and THb. The PPI is the percentage of coherent MAP-DHb (difference between oxygenated and deoxygenated hemoglobin, a marker of cerebral blood flow) epochs in a chosen time period. Neonates cooled for HIE were prospectively enrolled in an observational study in two neonatal intensive care units. In analyses adjusted for study site and encephalopathy level, all indices detected relationships between poor autoregulation in the first 6 h after rewarming with a higher injury score on MRI. Only HVx and PPI during hypothermia and the PPI during rewarming identified autoregulatory dysfunction associated with a poor outcome independent of study site and encephalopathy level. Our findings suggest that the accuracy of mathematical autoregulation algorithms in detecting the risk of brain injury or death may depend on temperature and postnatal age. Extending autoregulation monitoring beyond the standard 72 h of therapeutic hypothermia may serve as a method to provide personalized care by assessing the need for and efficacy of future therapies after the hypothermia treatment phase.

Indexed as

Brain InjuriesHypothermiaHypothermia, InducedHypoxia-Ischemia, BrainCerebrovascular CirculationHemoglobinsHomeostasisHumansInfant, NewbornHemoglobinsBrain injuryCerebral autoregulationHypothermiaMRINear infrared spectroscopyNeonatal hypoxia-ischemia

Identifiers

PMID35100588
PMCPMC9828944

What OpenQuestion holds

Textmetadata
LicenceTDM
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.