Evidence map›Paper›PMID 38326536›Full record

Observational studyNeurocritical care2024

Continuous Monitoring of Cerebral Autoregulation in Adults Supported by Extracorporeal Membrane Oxygenation.

Lucy Q Zhang, Henry Chang, Andrew Kalra, Mariyam Humayun, Kathryn R Rosenblatt, Vishank A Shah, Romergryko G Geocadin, Charles H Brown, Bo Soo Kim, Glenn J R Whitman and 3 more

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

Observational study in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Lucy Q ZhangDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Henry ChangDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Andrew KalraDivision of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mariyam HumayunDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Kathryn R RosenblattDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Vishank A ShahDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Romergryko G GeocadinDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA.
Charles H BrownDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bo Soo KimDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Glenn J R WhitmanDivision of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lucia Rivera-Lara *Department of Neurology and Center for Academic Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA.
Sung-Min Cho *Division of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, Baltimore, MD, USA. csungmi1@jhmi.edu.ORCID 0000-0002-5132-0958
HERALD Investigators

Funding

Consequences of Cardiac Arrest: Brain InjuryR01HL071568 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI GEOCADIN, ROMERGRYKO, THAKOR, NITISH VYOMESH · 2003 to 2022
$8.4M
Cerebral Autoregulation in the Cardiac Surgery Intensive Care Unit: Associations with Postoperative Delirium, Cognitive Change, and Biomarkers of Brain InjuryRF1AG072387 · NIA · JOHNS HOPKINS UNIVERSITY · PI BROWN, CHARLES HUGH, GOEDDEL, LEE ANDREW · 2021 to 2021
$1.2M
CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) studyK23HL157610 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Sung-Min Cho · 2022 to 2026
$797k
Medtronic RF1AG07238NHLBI Division of Intramural Research 1K23HL157610NHLBI Division of Intramural Research 5R01HL071568-18NHLBI NIH HHS K23 HL157610NHLBI NIH HHS L30 HL165486NHLBI NIH HHS R01 HL071568NIA NIH HHS RF1 AG072387
6 · The paper itself

Abstract

backgroundImpaired cerebral autoregulation (CA) is one of several proposed mechanisms of acute brain injury in patients supported by extracorporeal membrane oxygenation (ECMO). The primary aim of this study was to determine the feasibility of continuous CA monitoring in adult ECMO patients. Our secondary aims were to describe changes in cerebral oximetry index (COx) and other metrics of CA over time and in relation to functional neurologic outcomes.

methodsThis is a single-center prospective observational study. We measured COx, a surrogate measurement of cerebral blood flow measured by near-infrared spectroscopy, which is an index of CA derived from the moving correlation between mean arterial pressure (MAP) and slow waves of regional cerebral oxygen saturation. A COx value that approaches 1 indicates impaired CA. Using COx, we determined the optimal MAP (MAP

resultsFifteen patients (median age 57 years [interquartile range 47-69]) with 150 autoregulation measurements were included for analysis. Eleven were on veno-arterial ECMO (VA-ECMO), and four were on veno-venous ECMO (VV-ECMO). Mean COx was higher on postcannulation day 1 than on day 2 (0.2 vs. 0.09, p < 0.01), indicating improved CA over time. COx was higher in VA-ECMO patients than in VV-ECMO patients (0.12 vs. 0.06, p = 0.04). Median MAP

conclusionsIn ECMO patients, it is feasible to monitor CA continuously at the bedside. CA improved over time, most significantly between postcannulation days 1 and 2. CA was more impaired in VA-ECMO patients than in VV-ECMO patients. Spending less time outside MAP

Indexed as

Cerebrovascular CirculationExtracorporeal Membrane OxygenationHomeostasisSpectroscopy, Near-InfraredAgedArterial PressureFemaleHumansMaleMiddle AgedNeurophysiological MonitoringOximetryProspective StudiesCerebral autoregulationExtracorporeal membrane oxygenationNear-infrared spectroscopyNeurological outcomesOptimal perfusion pressure

Identifiers

PMID38326536
PMCPMC11303590

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Registered trials

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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.