Observational studyPediatric research2025
Assessing bedside measures of autonomic nervous system dysregulation in the PICU.
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 1 paper.
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.
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Who cites it
1 citing paper in PubMed.
- The association between neurologic pupillary index (NPi) and functional outcomes in critically ill children.BMC pediatrics · 2025Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAutonomic nervous system (ANS) dysregulation is common during critical illness and is often measured using heart rate variability (HRV). It is unknown if other forms of ANS function, such as pupillary light reflex and thermoregulation, are altered in critically ill children. We aimed to determine whether automated pupillometry and delta (central-to-peripheral) skin temperatures were associated with HRV.
methodsIn this prospective observational pilot, inclusion criteria were admission to the pediatric intensive care unit (ICU) and mechanical ventilation. HRV was calculated using age-adjusted integer HRV (HRVi). Automated pupillometry and skin temperatures were recorded during the first 72 h of admission. The primary outcomes were: (1) correlation between HRVi and Neurological Pupil index (NPi), and (2) correlation between HRVi and delta skin temperature.
resultsOf 29 patients enrolled, 18 had pupillometer data and 20 had temperature data. There were significant, small correlations between left and right NPi values and HRVi (r = 0.13, r = 0.12; p < 0.001), and delta skin temperatures and HRVi (r = 0.15, p < 0.001), which persisted after adjusting for confounders.
conclusionsAbnormal pupillary light response and decreased delta skin temperatures are associated with lower HRVi. If validated, pupillometry and skin temperature could be considered physiologic biomarkers of ANS dysregulation in critically ill children. IMPACT: While heart rate variability has strong associations with outcomes in critically ill children, there are limited data on other bedside tools of autonomic function in critically ill children. In this study, we found that pupillometry and skin temperature sensors correlate with heart rate variability in critically ill children. These physiological biomarkers may have a role in early detection of autonomic nervous system dysregulation.
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Registered trials
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.