Evidence map›Paper›PMID 35674046›Full record

ArticleStroke2022

Intraarterial Nimodipine Versus Induced Hypertension for Delayed Cerebral Ischemia: A Modified Treatment Protocol.

Miriam Weiss, Walid Albanna, Catharina Conzen-Dilger, Nick Kastenholz, Katharina Seyfried, Hani Ridwan, Martin Wiesmann, Michael Veldeman, Tobias Philip Schmidt, Murad Megjhani and 5 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

13 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 6 countries.

Miriam WeissDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0001-8820-0805
Walid AlbannaDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.
Catharina Conzen-DilgerDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0001-9979-5947
Nick KastenholzDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.
Katharina SeyfriedDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.
Hani RidwanDepartment of Diagnostic and Interventional Neuroradiology (H.R., M.W.), RWTH Aachen University, Germany.ORCID 0000-0001-5195-614X
Martin WiesmannDepartment of Diagnostic and Interventional Neuroradiology (H.R., M.W.), RWTH Aachen University, Germany.ORCID 0000-0002-8261-5513
Michael VeldemanDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0003-3648-6842
Tobias Philip SchmidtDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0001-6293-0025
Murad MegjhaniProgram for Hospital and Intensive Care Informatics, Department of Neurology (M.M., S.P.), Columbia University Irving Medical Center, NY.ORCID 0000-0002-7613-6444
Henna Schulze-SteinenDepartment of Intensive Care Medicine and Perioperative Care (H.S.-S.), RWTH Aachen University, Germany.
Hans ClusmannDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0001-8258-9346
Marinus Johannes Hermanus AriesDepartment of Intensive Care, Maastricht University Medical Center, Maastricht University, the Netherlands (M.J.H.A.).ORCID 0000-0001-5327-1275
Soojin ParkProgram for Hospital and Intensive Care Informatics, Department of Neurology (M.M., S.P.), Columbia University Irving Medical Center, NY.ORCID 0000-0002-3688-7307
Gerrit Alexander SchubertDepartment of Neurosurgery (M.W., W.A., C.C.-D., N.K., K.S., M.V., T.P.S., H.C., G.A.S.), RWTH Aachen University, Germany.ORCID 0000-0001-9135-6042
Norwegian Womens Public Health Association · NORWTH Aachen University · DEColumbia University Irving Medical Center · USMaastricht University Medical Centre · NLPhilips (United Kingdom) · GB

Funding

Multiparametric Prediction of Vasospasm after Subarachnoid HemorrhageK01ES026833 · NIEHS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI PARK, SOOJIN · 2015 to 2019
$1.1M
Machine Learning to Optimize Management of Acute Hydrocephalus PatientsR21NS113055 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI PARK, SOOJIN · 2020 to 2020
$446k
NIEHS NIH HHS K01 ES026833NINDS NIH HHS R21 NS113055
6 · The paper itself

Abstract

backgroundRescue treatment for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage can include induced hypertension (iHTN) and, in refractory cases, endovascular approaches, of which selective, continuous intraarterial nimodipine (IAN) is one variant. The combination of iHTN and IAN can dramatically increase vasopressor demand. In case of unsustainable doses, iHTN is often prioritized over IAN. However, evidence in this regard is largely lacking. We investigated the effects of a classical (iHTN+IAN) and modified (IAN

methodsRescue treatment for DCI was initiated with iHTN (target >180 mm Hg systolic) and escalated to IAN in refractory cases. Until July 2018, both iHTN and IAN were offered in cases refractory to iHTN alone. After protocol modification, iHTN target was preemptively lowered to >120 mm Hg when IAN was initiated (IAN

resultsN=29 and n=20 patients were treated according to the classical and modified protocol, respectively. Protocol modification resulted in a significant reduction of noradrenaline demand (iHTN+IAN 0.70±0.54 µg/kg per minute and IAN

conclusionsAssuming the potential of iHTN to be exhausted in case of refractory hypoperfusion, additional IAN may serve as a last-resort measure to bridge hypoperfusion in the DCI phase. With close monitoring, preemptive lowering of pressure target after induction of IAN may be a safe alternative to alleviate total noradrenaline load and potentially reduce complication rate.

Indexed as

Brain IschemiaHypertensionSubarachnoid HemorrhageVasospasm, IntracranialCerebral InfarctionClinical ProtocolsHumansNimodipineNorepinephrineObservational Studies as TopicNimodipineNorepinephrinebrain ischemiaGlasgow Outcome Scalenimodipinenorepinephrinesubarachnoid hemorrhage

Identifiers

PMID35674046
PMCPMC9329199
OpenAlexW4281618638

What OpenQuestion holds

Textmetadata
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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.