Evidence map›Paper›PMID 40023745›Full record

Observational studyBritish journal of anaesthesia2025

Regulation of cerebrovascular resistance below the lower limit of cerebral autoregulation during induced hypotension: an observational study.

Eline Kho, Rokus E C van den Dool, Sandjiv S Mahes, Oskar T Corsmit, Alexander P J Vlaar, Dave R Koolbergen, Denise P Veelo, Nicholaas H Sperna Weiland, Rogier V Immink

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

Observational study in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Trial
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.

Eline KhoDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Department of Intensive Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: e.kho@amsterdamumc.nl.
Rokus E C van den DoolDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Sandjiv S MahesDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Oskar T CorsmitDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Alexander P J VlaarDepartment of Intensive Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Laboratory of Experimental Intensive Care and Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Dave R KoolbergenCardio-thoracic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Denise P VeeloDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Nicholaas H Sperna WeilandDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
Rogier V ImminkDepartment of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo maintain adequate perfusion, cerebral blood flow (CBF) is preserved by changes in cerebrovascular resistance (CVR) inversely related to fluctuations in mean arterial blood pressure (MAP). It has been hypothesised that during progressive hypotension, a lower limit of cerebral autoregulation (LLCA) is reached beyond which cerebrovascular dilation becomes exhausted and CBF starts to decrease together with BP. We tested this hypothesis by assessing CVR above and below the LLCA.

methodsRadial arterial pressure, thermodilution cardiac output (CO), and mean middle cerebral artery blood velocity (MCAV

resultsFor 50 participants undergoing aortic root surgery who met inclusion criteria, LLCA was located at 58 (12) mm Hg, with a corresponding MCAV

conclusionsThe continuing decline of CVR below the LLCA indicated that brain vasculature is still able to react on changing BP. This implies that LLCA should not be regarded as a fixed point but rather a transitional zone between exhausted and normally functioning autoregulation.

Indexed as

Cerebrovascular CirculationHomeostasisHypotensionHypotension, ControlledVascular ResistanceAdultAgedArterial PressureBlood Flow VelocityBlood PressureCardiac OutputFemaleHumansMaleMiddle AgedMiddle Cerebral Arteryarterial pressurecerebral autoregulationcerebrovascular resistanceinduced hypotensionmiddle cerebral artery blood velocitytranscranial Doppler ultrasonography

Identifiers

PMID40023745
PMCPMC11947574

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.