Evidence map›Paper›PMID 41359999›Full record

Observational studyActa anaesthesiologica Scandinavica2026

Association of Cerebral Oxygenation During Prehospital Anaesthesia and Functional Outcome: A Prospective, Observational Multi-Centre Cohort Study of 1014 Patients.

Anssi Saviluoto, Lasse Raatiniemi, Simo Mäkelä, Tuukka Toivonen, Piritta Setälä, Hetti Kirves, Miretta Tommila, Pamela Toivonen, Simo Tukia, Jouni Nurmi

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04144803 (Brain Oxygenation During Prehospital Anesthesia), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT04144803 unknown statusnot on this map

Brain Oxygenation During Prehospital Anesthesia: an Observational Study (The BOPRA Study)

TypeobservationalSponsorHelsinki University Central HospitalRan2019 to 2023Enrolled1,300ConditionsCritically Ill, Major Trauma, Anesthesia, EmergenciesArmsCerebral near-infrared spectroscopy
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
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

10 authors.

Anssi SaviluotoEmergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0001-5052-4628
Lasse RaatiniemiHEMS Unit, Division of Prehospital Emergency Care, Oulu University Hospital, Oulu, Finland.ORCID 0000-0001-5537-9749
Simo MäkeläFinnish Institute for Health and Welfare, Finland.ORCID 0000-0002-8860-4495
Tuukka ToivonenFinnHEMS, Vantaa, Finland.ORCID 0000-0003-0390-2627
Piritta SetäläEmergency Medical Services, Centre for Prehospital Emergency Care, Wellbeing Services County of Pirkanmaa, Tampere, Finland.ORCID 0000-0003-0850-8485
Hetti KirvesEmergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Miretta TommilaDepartment of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
Pamela ToivonenCentre for Prehospital Care, Institute of Clinical Medicine, Kuopio University Hospital, Kuopio, Finland.
Simo TukiaEmergency Medical Services, HEMS Unit, Wellbeing Services County of Lapland, Rovaniemi, Finland.
Jouni NurmiEmergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-1920-4869

Funding

FinnHEMSHelsingin ja Uudenmaan Sairaanhoitopiiri state funding, TYH2021224 and TYH2022320
6 · The paper itself

Abstract

backgroundMany patients undergoing prehospital anaesthesia may be at risk of inadequate cerebral oxygenation due to underlying conditions or adverse events like hypotension or hypoxia. This study examined whether a decrease in regional cerebral oxygen saturation (rSO

methodsWe conducted a prospective, observational study including adult patients anaesthetised by six prehospital critical care teams. A relative cerebral desaturation event (rCDE) was defined as a ≥ 10% decrease in rSO

resultsAmong 1014 patients, 199 experienced an rCDE, with 125 (63%) having supraphysiological baseline. rCDE was not associated with outcomes. Of 182 patients with aCDE, 30-day favourable outcomes were not significantly different (30% vs. 36%, p = 0.14, adjusted OR 0.92, 95% confidence interval 0.62-1.34). However, aCDE was associated with lower 30-day survival (46% vs. 58%, p = 0.006) and less favourable 1-year outcomes (31% vs. 41%, p = 0.043). Adjusted analyses showed no significant associations.

conclusionAn rCDE was not associated with worse functional outcomes. While aCDEs were linked to unfavourable outcomes in unadjusted analyses, these associations were not significant after adjustment, highlighting the complexity of interpreting NIRS in heterogeneous populations. Condition-specific studies are needed to clarify its role. EDITORIAL COMMENT: Cerebral oxygen delivery may be jeopardized in critically ill patients undergoing prehospital anaesthesia. This study assessed near-infrared spectroscopy on the forehead in a large number of cases requiring general anaesthesia and subsequent transportation to hospital by helicopter. In unadjusted analysis, patients with an at least 10% decline in forehead saturation had higher survival and better functional outcome, whereas those with a forehead saturation below 60% had lower survival and worse functional outcome. Upon multivariable regression, age, patient category, systemic oxygen saturation and Glasgow Coma Scale score were independent predictors of worse outcomes, but forehead oxygen saturation was not. NIRS-measured forehead saturation decrease appears to associate in a complex fashion with more traditional predictors of patient outcomes. Whether effects of resuscitation interventions like these can be assessed reliably by NIRS is not yet well understood.

trial registrationThe study protocol was published beforehand on clinicaltrials.gov (NCT04144803) on 7th October 2019.

Indexed as

AnesthesiaBrainEmergency Medical ServicesOxygenOxygen SaturationAdultAgedCerebrovascular CirculationCohort StudiesFemaleHumansMaleMiddle AgedProspective StudiesSpectroscopy, Near-InfraredTreatment OutcomeOxygenairway managementcritical careemergency medical servicesnear‐infraredrapid sequence induction and intubationspectroscopy

Identifiers

PMID41359999
PMCPMC12685386

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.