Evidence map›Paper›PMID 39548295›Full record

Observational studyPediatric research2025

Cardiovascular responses as predictors of mortality in children with acute brain injury.

Marta João Silva, Hernâni Gonçalves, Rute Almeida, Claúdia Camila Dias, Ana Isabel Almeida, Ana Paula Rocha, Cristina Granja, Maria João Baptista, Inês Azevedo

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Pediatric research, 2025. 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. Article
  2. Article
  3. Review
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

9 authors.

Marta João SilvaPediatric Intensive Care Unit, São João University Hospital Center, Porto, Portugal. martajoaosilva@gmail.com.ORCID 0000-0002-5627-7282
Hernâni GonçalvesCINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Rute AlmeidaCINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Claúdia Camila DiasCINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Ana Isabel AlmeidaNeuroradiology Department, São João University Hospital Center, Porto, Portugal.
Ana Paula RochaMathematics Center, University of Porto, Porto, Portugal.
Cristina GranjaCINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal.
Maria João BaptistaGinecology-Obstetrics and Pediatrics Department, Faculty of Medicine, University of Porto, Porto, Portugal.
Inês AzevedoGinecology-Obstetrics and Pediatrics Department, Faculty of Medicine, University of Porto, Porto, Portugal.

Funding

FCT—Fundação para a Ciência e a Tecnologia, I.P.
6 · The paper itself

Abstract

backgroundInvestigate the utility of cardiovascular responses such as heart rate (HR), blood pressure (BP), and heart rate variability (HRV) in the prognosis of children with acute acquired brain injury (ABI).

methodsChildren under 18 years with severe acute acquired brain injury (ABI) who survived at least 12 h after PICU admission were included in a prospective observational cohort in a tertiary academic PICU. Physiological variables, neurological data, laboratory tests (chemistry and hematology), and medications were recorded within 12 h of admission. Linear and nonlinear HRV indices, CT scans, PICU scores, and survival rates were evaluated.

resultsSeventy-two children, median age 10.7 years (IQR 4.1-13.6), were eligible for the study; 28 (38.9%) were diagnosed with brain death (BD). Tachycardia, SBP and MBP < 5th percentile, and MBP and DBP> 99th percentile were significantly associated with mortality. Poincaré SD1/SD2 was significantly associated with mortality after adjusting for age, sex and ongoing medication.

conclusionTachycardia, systolic hypotension and median hypo and hypertension were associated to mortality in children with severe ABI. While further validation through larger, multicenter studies is necessary, the Poincaré SD1/SD2 ratio has shown promise as a prognostic tool for predicting mortality in children with severe ABI. IMPACT STATEMENT: This study explores cardiovascular changes, including heart rate and blood pressure, and linear/nonlinear HRV measures using ECG at 1000 Hz, and compare them with other prognostic factors like brain tomography and PICU scores. Tachycardia, hypo/hypertension in the early hours after admission are linked to early mortality in children with severe traumatic and non-traumatic brain injury. Linear/non-linear measures of HRV were also related to survival. Higher HRV values indicating better survival chances. We identified Poincaré SD1/SD2 ratio as a promising tool for predicting mortality in children with severe ABI.

Indexed as

Brain InjuriesHeart RateAdolescentBlood PressureChildChild, PreschoolFemaleHumansIntensive Care Units, PediatricMalePrognosisProspective StudiesTachycardia

Identifiers

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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.