Evidence map›Paper›PMID 39192101›Full record

Observational studyNeurocritical care2025

Oxygen-Based Autoregulation Indices Associated with Clinical Outcomes and Spreading Depolarization in Aneurysmal Subarachnoid Hemorrhage.

Andrew P Carlson, Thomas Jones, Yiliang Zhu, Masoom Desai, Ali Alsarah, C William Shuttleworth

Abstract readObservational Study
In one paragraph

Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Review
  6. Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Andrew P CarlsonDepartment of Neurosurgery, University of Virginia School of Medicine, Charlottesville, VA, USA. andrewcarlson@virginia.edu.ORCID 0000-0003-2189-3699
Thomas JonesDepartment of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Yiliang ZhuDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Masoom DesaiDepartment of Neurology, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Ali AlsarahDepartment of Neurology, Harvard University, Boston, MA, USA.
C William ShuttleworthDepartment of Neuroscience, University of New Mexico School of Medicine, Albuquerque, NM, USA.

Funding

University of New Mexico (UNM) Center for Brain Recovery and RepairP20GM109089 · NIGMS · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI SHUTTLEWORTH, CLAUDE W · 2015 to 2024
$22.7M
Clinical Stimulation and Spreading DepolarizationR01NS128006 · NINDS · UNIVERSITY OF VIRGINIA · PI Andrew Phillip Carlson · 2023 to 2026
$1.6M
NIGMS NIH HHS P20 GM109089NIGMS NIH HHS P20GM109089NINDS NIH HHS R01 NS128006
6 · The paper itself

Abstract

backgroundImpairment in cerebral autoregulation has been proposed as a potentially targetable factor in patients with aneurysmal subarachnoid hemorrhage (aSAH); however, there are different continuous measures that can be used to calculate the state of autoregulation. In addition, it has previously been proposed that there may be an association of impaired autoregulation with the occurrence of spreading depolarization (SD) events.

methodsStudy participants with invasive multimodal monitoring and aSAH were enrolled in an observational study. Autoregulation indices were prospectively calculated from this database as a 10 s moving correlation coefficient between various cerebral blood flow (CBF) surrogates and mean arterial pressure (MAP). In study participants with subdural electrocorticography (ECoG) monitoring, SD was also scored. Associations between clinical outcomes using the modified Rankin scale and occurrence of either isolated or clustered SD were assessed.

resultsA total of 320 study participants were included, 47 of whom also had ECoG SD monitoring. As expected, baseline severity factors, such as modified Fisher scale score and World Federation of Neurosurgical Societies scale grade, were strongly associated with the clinical outcome. SD probability was related to blood pressure in a triphasic pattern, with a linear increase in probability below MAP of ~ 100 mm Hg. Multiple autoregulation indices were available for review based on moving correlations between mean arterial pressure (MAP) and various surrogates of cerebral blood flow (CBF). We calculated the pressure reactivity (PRx) using two different sources for intracranial pressure (ICP). We calculated the oxygen reactivity (ORx) using the partial pressure of brain tissue oxygen (PbtO

conclusionsImpairment in autoregulation in aSAH is associated with worse clinical outcomes and occurrence of SD when using ORx and OSRx. Impaired autoregulation precedes SD occurrence. Targeting the optimal MAP or cerebral perfusion pressure in patients with aSAH should use ORx and/or OSRx as the input function rather than intracranial pressure.

Indexed as

Arterial PressureCerebrovascular CirculationCortical Spreading DepressionHomeostasisOutcome Assessment, Health CareOxygenSubarachnoid HemorrhageAdultAgedElectrocorticographyFemaleHumansMaleMiddle AgedNeurophysiological MonitoringSeverity of Illness IndexOxygenCerebral autoregulationCerebral ischemiaDelayed cerebral ischemiaSpreading depolarizationSubarachnoid hemorrhage

Identifiers

PMID39192101
PMCPMC11950063

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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.