Trial reportNeurocritical care2025
Does Targeting CPP at CPPopt Actually Improve Cerebrovascular Reactivity? A Secondary Analysis of the COGiTATE Randomized Controlled Trial.
Trial report in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07287358 (CPPopt Guided Therapy), which is not on this map. Cited by 10 papers.
What it found
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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.
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.
CPPopt Guided Therapy: Assessment of Target Effectiveness - II
Who cites it
10 citing papers in PubMed.
- Advances in Multimodality Monitoring in Traumatic Brain Injury.Current neurology and neuroscience reports · 2026Review
- A Harmonised Protocol for the Use of PRx in Adult and Paediatric TBI Patients with ICP Monitoring: CLINICCA Workgroup Output.Neurocritical care · 2026Article
- Noninvasive neurophysiological diagnostics of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a scoping review.Acta neurochirurgica · 2026Article
- Autoregulation-guided intracranial pressure and cerebral perfusion pressure targets in different subtypes and characteristics of traumatic brain injury.Critical care (London, England) · 2026Observational
- Intercerebral autoregulation index consistency in the derivation of CPPopt, MAPopt, and BISopt in humans: A scoping review.Physiological reports · 2025Article
- The lower limit margin: a determinant of autoregulatory sensitivity to changes in cerebral perfusion pressure.Critical care (London, England) · 2025Article
- Visualizations of autoregulatory insults in moderate-to-severe paediatric traumatic brain injury: a secondary analysis from the multicentre STARSHIP trial.Critical care (London, England) · 2025Article
- Cerebral perfusion pressure targets after traumatic brain injury: a reappraisal.Critical care (London, England) · 2025Observational
- Continuous personalized cerebrovascular reactivity-based physiologic metrics in neurocritical care: a narrative review of the current landscape, limitations, and future directions.Frontiers in physiology · 2025Review
- Liver transplant and impact on cerebral autoregulation: a systematic scoping review.Frontiers in transplantation · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
backgroundThe 'CPPopt-Guided Therapy: Assessment of Target Effectiveness' (COGiTATE) randomised controlled trial demonstrated the feasibility and safety of targeting an automated cerebral perfusion pressure (CPP) tailored to optimize cerebrovascular autoregulation (CPPopt) in patients with traumatic brain injury (TBI) requiring intracranial pressure management. The average values of the autoregulation index known as the pressure reactivity index (PRx) were not different between the intervention (CPP target = CPPopt) and control (CPP target = 60-70 mmHg) groups of the trial. This secondary analysis was performed to investigate whether: (1) in the intervention group, PRx was closer to PRxopt (PRx at CPPopt) values, indicating a more preserved reactivity, as opposed to in the control group; (2) in the intervention group, patients experienced lower hourly PRx when CPP was close to the CPPopt-based target.
methodsWe analyzed data from the 28 and 32 patients randomized to the control and intervention groups of the COGiTATE study, respectively. We compared hourly averaged ΔPRx (PRx minus PRxopt, where PRxopt is PRx at CPPopt) between the two groups, focusing on periods of globally preserved/homogeneous autoregulation (negative PRxopt). For each patient in the intervention group, PRx values in periods when ΔCPP (CPP minus CPPopt target) was between -5 and + 5 mm Hg were compared to values in periods when ΔCPP was outside this range.
resultsThe median ΔPRx was significantly lower in the intervention group for negative PRxopt (Mann-Whitney U-test, p < 0.001). For each patient in this group, the median PRx was lower in periods when CPP was close to the CPPopt-based target (Wilcoxon test, p < 0.001).
conclusionsDespite no statistically significant difference in the grand mean PRx, our results suggest that targeting CPPopt does provide a way of improving cerebrovascular reactivity in patients with TBI, offering a rational intervention for trials that address this issue. We also bring insight into aspects of the PRx/CPP relationship that should be considered for autoregulation-guided management for future clinical protocols and trials design.
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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.