Evidence map›Paper›PMID 38814348›Full record

SynthesisActa neurochirurgica2024

Brain tissue oxygen plus intracranial pressure monitoring versus isolated intracranial pressure monitoring in patients with traumatic brain injury: an updated meta-analysis of randomized controlled trials.

Hugo Nunes Pustilnik, Gabriel Souza Medrado-Nunes, Gabriel Araújo Cerqueira, Davi Amorim Meira, Beatriz Lopes Bernardo da Cunha, Silvio Porto Junior, Jefferson Heber Marques Fontes, Matheus Gomes da Silva da Paz, Tancredo Alcântara, Leonardo Miranda de Avellar

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. 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

10 authors.

Hugo Nunes PustilnikSalvador University, Salvador, Brazil. hugonpustilnik@gmail.com.ORCID 0009-0006-1774-2651
Gabriel Souza Medrado-NunesFederal University of Bahia, Salvador, Brazil.
Gabriel Araújo CerqueiraBahiana School of Medicine and Public Health, Salvador, Brazil.
Davi Amorim MeiraBahiana School of Medicine and Public Health, Salvador, Brazil.
Beatriz Lopes Bernardo da CunhaUniversity of Bahia State, Salvador, Brazil.
Silvio Porto JuniorBahiana School of Medicine and Public Health, Salvador, Brazil.
Jefferson Heber Marques FontesMetropolitan Union of Education and Culture, Salvador, Brazil.
Matheus Gomes da Silva da PazNeurosurgery Department, General Hospital Roberto Santos, Salvador, Brazil.
Tancredo AlcântaraNeurosurgery Department, General Hospital Roberto Santos, Salvador, Brazil.
Leonardo Miranda de AvellarNeurosurgery Department, General Hospital Roberto Santos, Salvador, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntracranial pressure (ICP) monitoring plays a key role in patients with traumatic brain injury (TBI), however, cerebral hypoxia can occur without intracranial hypertension. Aiming to improve neuroprotection in these patients, a possible alternative is the association of Brain Tissue Oxygen Pressure (PbtO2) monitoring, used to detect PbtO2 tension.

methodWe systematically searched PubMed, Embase and Cochrane Central for RCTs comparing combined PbtO2 + ICP monitoring with ICP monitoring alone in patients with severe or moderate TBI. The outcomes analyzed were mortality at 6 months, favorable outcome (GOS ≥ 4 or GOSE ≥ 5) at 6 months, pulmonary events, cardiovascular events and sepsis rate.

resultsWe included 4 RCTs in the analysis, totaling 505 patients. Combined PbtO2 + ICP monitoring was used in 241 (47.72%) patients. There was no significant difference between the groups in relation to favorable outcome at 6 months (RR 1.17; 95% CI 0.95-1.43; p = 0.134; I

conclusionsOur findings suggest that combined PbtO2 + ICP monitoring does not change outcomes such as mortality, functional recovery, cardiovascular events or sepsis. Furthermore, we found a higher risk of pulmonary events in patients undergoing combined monitoring.

Indexed as

Brain Injuries, TraumaticIntracranial PressureRandomized Controlled Trials as TopicBrainHumansIntracranial HypertensionMonitoring, PhysiologicNeurophysiological MonitoringOxygenOxygenBrain tissue oxygen monitoringIntracranial pressure monitoringMultimodal monitoringNeurointensive careTraumatic brain injury

Identifiers

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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.