Evidence map›Paper›PMID 38904977›Full record

Observational studyCritical care explorations2024

Microvascular Autoregulation in Skeletal Muscle Using Near-Infrared Spectroscopy and Derivation of Optimal Mean Arterial Pressure in the ICU: Pilot Study and Comparison With Cerebral Near-Infrared Spectroscopy.

Amirali Mirsajadi, Dustin Erickson, Soumya Alias, Logan Froese, Amanjyot Singh Sainbhi, Alwyn Gomez, Raju Majumdar, Isuru Herath, Maggie Wilson, Ryan Zarychanski and 3 more

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

Observational study in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  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

13 authors.

Amirali MirsajadiDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Dustin EricksonSection of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Soumya AliasSection of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Logan FroeseDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Amanjyot Singh SainbhiDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Alwyn GomezDivision of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada.
Raju MajumdarSection of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Isuru HerathDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Maggie WilsonSection of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Ryan ZarychanskiSection of Critical Care Medicine, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Frederick A ZeilerDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Asher A MendelsonDepartment of Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
Microvasclar Monitoring in Circulatory Shock and Sepsis (MiMICSS) Investigators and the Canadian Critical Care Translational Biology Group

Funding

University of Manitoba Endowed Manitoba Public Insurance (MPI) Chair in NeuroscienceUniversity of Manitoba Graduate Fellowship ProgramUniversity of Manitoba Lyonel G Israels Endowed Research Chair in HematologyUniversity of Manitoba, Department of Internal Medicine New Investigator Operating Grant
6 · The paper itself

Abstract

importanceMicrovascular autoregulation (MA) maintains adequate tissue perfusion over a range of arterial blood pressure (ABP) and is frequently impaired in critical illness. MA has been studied in the brain to derive personalized hemodynamic targets after brain injury. The ability to measure MA in other organs is not known, which may inform individualized management during shock.

objectivesThis study determines the feasibility of measuring MA in skeletal muscle using near-infrared spectroscopy (NIRS) as a marker of tissue perfusion, the derivation of optimal mean arterial pressure (MAPopt), and comparison with indices from the brain.

designProspective observational study.

settingMedical and surgical ICU in a tertiary academic hospital.

participantsAdult critically ill patients requiring vasoactive support on the first day of ICU admission. MAIN OUTCOMES AND MEASURES: Fifteen critically ill patients were enrolled. NIRS was applied simultaneously to skeletal muscle (brachioradialis) and brain (frontal cortex) while ABP was measured continuously via invasive catheter. MA correlation indices were calculated between ABP and NIRS from skeletal muscle total hemoglobin (MVx), muscle tissue saturation index (MOx), brain total hemoglobin (THx), and brain tissue saturation index (COx). Curve fitting algorithms derive the MAP with the lowest correlation index value, which is the MAPopt.

resultsMAPopt values were successfully calculated for each correlation index for all patients and were frequently (77%) above 65 mm Hg. For all correlation indices, median time was substantially above impaired MA threshold (24.5-34.9%) and below target MAPopt (9.0-78.6%). Muscle and brain MAPopt show moderate correlation (MVx-THx r = 0.76, p < 0.001; MOx-COx r = 0.69, p = 0.005), with a median difference of -1.27 mm Hg (-9.85 to -0.18 mm Hg) and 0.05 mm Hg (-7.05 to 2.68 mm Hg). CONCLUSIONS AND RELEVANCE: This study demonstrates, for the first time, the feasibility of calculating MA indices and MAPopt in skeletal muscle using NIRS. Future studies should explore the association between impaired skeletal muscle MA, ICU outcomes, and organ-specific differences in MA and MAPopt thresholds.

Indexed as

Arterial PressureCritical IllnessHomeostasisIntensive Care UnitsMuscle, SkeletalSpectroscopy, Near-InfraredAdultAgedBrainFemaleHumansMaleMicrocirculationMiddle AgedPilot ProjectsProspective Studies

Identifiers

PMID38904977
PMCPMC11196085

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.