Evidence map›Paper›PMID 38351299›Full record

ArticleNeurocritical care2024

The Effect of Recruitment Maneuvers on Cerebrovascular Dynamics and Right Ventricular Function in Patients with Acute Brain Injury: A Single-Center Prospective Study.

Filippo Sanfilippo, Agnieszka Uryga, Lorenzo Ball, Denise Battaglini, Ida Giorgia Iavarone, Peter Smielewski, Erta Beqiri, Marek Czosnyka, Nicolò Patroniti, Chiara Robba

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

Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
4.1field-weighted citation impact, top 6% 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

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Mechanical ventilation in acute brain injury.Breathe (Sheffield, England) · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Filippo SanfilippoDepartment of General Surgery and Medico-Surgical Specialties, School of Anaesthesia and Intensive Care, University of Catania, Catania, Italy.
Agnieszka UrygaDepartment of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland.
Lorenzo BallDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Denise BattagliniDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
Ida Giorgia IavaroneAnesthesia and Intensive Care, IRCCS Policlinico San Martino, Largo Rosanna Benzi, 16100, Genoa, Italy.
Peter SmielewskiBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Erta BeqiriBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Marek CzosnykaBrain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Nicolò PatronitiDepartment of Biomedical Engineering, Wroclaw University of Science and Technology, Wrocław, Poland.
Chiara RobbaDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy. kiarobba@gmail.com.ORCID 0000-0003-1628-3845
Ospedale Policlinico San Martino · ITUniversity of Cambridge · GBWrocław University of Science and Technology · PLUniversity of Catania · ITUniversity of Genoa · IT

Funding

MRF MR N013433-1Narodowe Centrum Nauki UMO-2022/47/D/ST7/00229
6 · The paper itself

Abstract

backgroundOptimization of ventilatory settings is challenging for patients in the neurointensive care unit, requiring a balance between precise gas exchange control, lung protection, and managing hemodynamic effects of positive pressure ventilation. Although recruitment maneuvers (RMs) may enhance oxygenation, they could also exert profound undesirable systemic impacts.

methodsThe single-center, prospective study investigated the effects of RMs (up-titration of positive end-expiratory pressure) on multimodal neuromonitoring in patients with acute brain injury. Our primary focus was on intracranial pressure and secondarily on cerebral perfusion pressure (CPP) and other neurological parameters: cerebral autoregulation [pressure reactivity index (PRx)] and regional cerebral oxygenation (rSO

resultsThirty-two patients were enrolled in the study. RMs resulted in increased intracranial pressure (Δ = 4.8 mm Hg) and reduced CPP (ΔCPP = -12.8 mm Hg) and mean arterial pressure (difference in mean arterial pressure = -5.2 mm Hg) (all p < 0.001). Cerebral autoregulation worsened (ΔPRx = 0.31 a.u.; p < 0.001). Despite higher systemic oxygenation (difference in partial pressure of O

conclusionsIn patients with acute brain injury, RMs appear to have adverse effects on cerebral hemodynamics. These findings might be partially explained by RM's impact on RV function. Further advanced echocardiography monitoring is required to prove this hypothesis.

Indexed as

Brain InjuriesCerebrovascular CirculationPositive-Pressure RespirationAdultAgedFemaleHomeostasisHumansIntracranial PressureMaleMiddle AgedProspective StudiesVentricular Function, RightCerebral autoregulationCerebral perfusionEchocardiographyIntracranial pressureIntrathoracic pressureMean arterial pressure

Identifiers

PMID38351299
PMCPMC11335957
OpenAlexW4391770812

What OpenQuestion holds

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LicenceCC BY
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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.