Evidence map›Paper›PMID 37067617›Full record

ArticleActa neurochirurgica2023

Associations between intracranial pressure thresholds and multimodal monitoring in acute traumatic neural injury: a scoping review.

Kevin Y Stein, Fiorella Amenta, Alwyn Gomez, Logan Froese, Amanjyot Singh Sainbhi, Nuray Vakitbilir, Izabella Marquez, Frederick A Zeiler

Abstract readScoping Review
PubMed Publisher
In one paragraph

Article in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

8 authors at 2 institutions in 3 countries.

Kevin Y SteinBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada. steink34@myumanitoba.ca.ORCID 0000-0002-5983-008X
Fiorella AmentaBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.
Alwyn GomezSection of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.ORCID 0000-0002-3737-2065
Logan FroeseBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.ORCID 0000-0002-6076-0189
Amanjyot Singh SainbhiBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.ORCID 0000-0003-3231-5683
Nuray VakitbilirBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.ORCID 0000-0003-2764-145X
Izabella MarquezBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.
Frederick A ZeilerBiomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.ORCID 0000-0003-1737-0510
University of Manitoba · CAUniversity of Cambridge · GB

Funding

CIHR
6 · The paper itself

Abstract

backgroundCurrent moderate/severe traumatic brain injury (TBI) guidelines suggest the use of an intracranial pressure (ICP) treatment threshold of 20 mmHg or 22 mmHg. Over the past decade, the use of various cerebral physiology monitoring devices has been incorporated into neurocritical care practice and termed "multimodal monitoring." Such modalities include those that monitor systemic hemodynamics, systemic and brain oxygenation, cerebral blood flow (CBF), cerebral autoregulation, electrophysiology, and cerebral metabolism. Given that the relationship between ICP and outcomes is not yet entirely understood, a comprehensive review of the literature on the associations between ICP thresholds and multimodal monitoring is still needed.

methodsWe conducted a scoping review of the literature for studies that present an objective statistical association between ICP above/below threshold and any multimodal monitoring variable. MEDLINE, BIOSIS, Cochrane library, EMBASE, Global Health, and SCOPUS were searched from inception to July 2022 for relevant articles. Full-length, peer-reviewed, original works with a sample size of ≥50 moderate-severe TBI patients were included in this study.

resultsA total of 13 articles were deemed eligible for final inclusion. The included articles were significantly heterogenous in terms of their designs, demographics, and results, making it difficult to draw any definitive conclusions. No literature describing the association between guideline-based ICP thresholds and measures of brain electrophysiology, cerebral metabolism, or direct metrics of CBF was found.

conclusionThere is currently little literature that presents objective statistical associations between ICP thresholds and multimodal monitoring physiology. However, overall, the literature indicates that having ICP above guideline based thresholds is associated with increased blood pressure, increased cardiac decoupling, reduced parenchymal brain oxygen tension, and impaired cerebral autoregulation, with no association with CBF velocity within the therapeutic range of ICP. There was insufficient literature to comment on other multimodal monitoring measures.

Indexed as

Brain InjuriesBrain Injuries, TraumaticCerebrovascular CirculationHemodynamicsHomeostasisHumansIntracranial PressureMonitoring, PhysiologicAcute traumatic neural injuryICP thresholdsMultimodal monitoringTBI

Identifiers

PMID37067617
OpenAlexW4366083171

What OpenQuestion holds

Textmetadata
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.