Evidence map›Paper›PMID 40677967›Full record

ArticleResuscitation plus2025

Transcranial Doppler goal-directed therapy after cardiac arrest (GOODYEAR): a feasibility study.

Juliette Meunier, Nicolas Engrand, Patrick Saulnier, Nicolas Deye, Mickaël Landais, Alain Cariou, Christophe Guitton, Nicolas Chudeau

Registry-linked trialAbstract read
In one paragraph

Article in Resuscitation plus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04000334 (Early Transcranial Doppler Goal Directed Therapy After Cardiac Arrest), which is not on this 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.

NCT04000334 naterminatednot on this map

Early Transcranial Doppler Goal Directed Therapy After Cardiac Arrest: a Pilot Study

TypeinterventionalSponsorCentre Hospitalier le MansRan2020 to 2023Enrolled20ConditionsCardiac Arrest, Cerebral Lesion, Ischemic Encephalopathy, Ischemic Reperfusion InjuryArmsMAP increased to optimize cerebral blood flow, MAP between 65 and 85 mmHg
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

8 authors.

Juliette MeunierIntensive Care Unit, Le Mans Hospital, Le Mans, France.
Nicolas EngrandAnaesthesia and Neuro-critical Care, Rothschild Foundation Hospital, Paris, France.
Patrick SaulnierMethodology and Biostatistics Department, Angers University Hospital, Angers, France.
Nicolas DeyeMedical and Toxicological Intensive Care Unit, Lariboisière Hospital, AP-HP, Paris, France.
Mickaël LandaisIntensive Care Unit, Le Mans Hospital, Le Mans, France.
Alain CariouMedical Intensive Care Unit, AP-HP Paris Cité University, Cochin Hospital, Paris, France.
Christophe GuittonIntensive Care Unit, Le Mans Hospital, Le Mans, France.
Nicolas ChudeauIntensive Care Unit, Le Mans Hospital, Le Mans, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: Hypoxic Ischemic Brain Injury is a major cause of death after cardiac arrest. Identifying optimal mean arterial pressure (MAP) targets to restore brain oxygen delivery remains challenging. This study assessed the feasibility of using transcranial Doppler to guide individualised MAP management in post-cardiac arrest patients. Methods: In this single-centre prospective feasibility study, post-cardiac arrest patients were enrolled after intensive care unit admission. After induction of targeted temperature management (TTM) and control of systemic secondary brain insults determinants, cerebral hypoperfusion was screened using transcranial Doppler. A MAP challenge was performed in patients with abnormal transcranial Doppler findings to assess cerebral vascular responsiveness to increased MAP. Jugular bulb oximetry was concurrently used to evaluate cerebral oxygenation. Results: A total of 172 patients were screened, and 20 (11.6%) were assessable using transcranial Doppler. After optimisation of cerebral blood flow determinants, 3 patients (15%) showed signs of cerebral hypoperfusion based on transcranial Doppler measurements. A MAP challenge was performed in two of these patients, without normalisation of transcranial Doppler values and with an estimated increase in intracranial pressure. No significant association was found between transcranial Doppler findings and either cerebral oxygenation parameters or neurological outcome. Baseline SjvO Conclusions: Implementing an individualised MAP management strategy guided by transcranial Doppler was challenging, with few patients eligible for evaluation. Still, transcranial Doppler identified a small group with persistent cerebral hypoperfusion despite optimised cerebral blood flow parameters. The study underscored technical and physiological limitations of this approach, which should inform the design and relevance of a larger trial to assess its clinical value.Trial registration: https://www.clinicaltrials.gov NCT04000334.

Indexed as

Arterial blood pressureCardiac arrestCerebral autoregulationHypoxic ischemic brain injury

Identifiers

PMID40677967
PMCPMC12270008

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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.