Evidence map›Paper›PMID 41396561›Full record

ArticleIntensive care medicine experimental2025

The role of transcranial Doppler in predicting the incidence and prognosis of sepsis-associated encephalopathy.

Hanady Mohammed Elfeky, Mohamed Basyouni Helal, Reham Naser Sherif, Sarah A Nada, Walaa Samy Mokhtar, Hatem Amin AttaAllah, Yasser Ibrahim Fathy, Hala Mohamed Koptan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine experimental, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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

2 citing papers in PubMed.

  1. Review
  2. 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.

Hanady Mohammed ElfekyCritical Care Medicine Department, Faculty of Medicine, Menoufia University, Shibin el Kom, 35211, Menoufia, Egypt. hanadymhmmd@gmail.com.ORCID http://orcid.org/0009-0000-0764-865X
Mohamed Basyouni HelalFaculty of Medicine, Menoufia University, Shibin el Kom, Menoufia, Egypt.ORCID http://orcid.org/0009-0005-5141-2376
Reham Naser SherifCritical Care Medicine Department, Faculty of Medicine, Menoufia University, Shibin el Kom, 35211, Menoufia, Egypt.ORCID http://orcid.org/0009-0001-5609-2595
Sarah A NadaFaculty of Medicine, Menoufia University, Shibin el Kom, Menoufia, Egypt.ORCID http://orcid.org/0000-0003-2592-2047
Walaa Samy MokhtarCritical Care Medicine Department, Faculty of Medicine, Menoufia University, Shibin el Kom, 35211, Menoufia, Egypt.ORCID http://orcid.org/0009-0006-5343-8825
Hatem Amin AttaAllahAnesthesia, Intensive Care, and Pain Management Department, Faculty of Medicine, Menoufia University, Shibin el Kom, Menoufia, Egypt.ORCID http://orcid.org/0009-0005-3523-6907
Yasser Ibrahim FathyAnesthesia, Intensive Care, and Pain Management Department, Faculty of Medicine, Menoufia University, Shibin el Kom, Menoufia, Egypt.ORCID http://orcid.org/0000-0001-5587-7967
Hala Mohamed KoptanAnesthesia, Intensive Care, and Pain Management Department, Faculty of Medicine, Menoufia University, Shibin el Kom, Menoufia, Egypt.ORCID http://orcid.org/0009-0000-2239-378X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSepsis-associated encephalopathy (SAE) is a common complication of sepsis, contributing to poor outcomes and increased mortality. Early detection remains challenging due to the absence of observable direct brain injury. Transcranial Doppler (TCD) ultrasonography provides a non-invasive, bedside tool for assessing cerebral hemodynamics and may help identify patients at risk. SAE was defined as new-onset delirium (positive CAM-ICU) or unexplained coma (GCS < 8) not attributable to structural or metabolic causes. This study aimed to evaluate the role of TCD in predicting the incidence and prognosis of SAE in septic patients admitted to the ICU.

methodsThis prospective cohort study included 93 patients with sepsis. Demographic, clinical, and laboratory data were recorded upon admission. Daily TCD was performed for seven consecutive days to measure the pulsatility index (PI) and resistive index (RI). Neurological dysfunction was assessed daily using the Confusion Assessment Method for the ICU (CAM-ICU) and the Glasgow Coma Scale (GCS).

resultsA total of 93 patients were included, of whom 44 (47.3%) developed SAE. SAE patients showed greater illness severity, with higher median SOFA (6 [5-7] vs. 5 [3-6], p < 0.001) and APACHE II (14 [12-17] vs. 11 [9-14], p < 0.001) scores, and higher 28-day mortality (61.4% vs. 22.4%, p < 0.001). The median PI and RI were consistently higher in SAE patients across all study days, while the mean flow velocity (mFV) was lower. PI on day 1 had the best accuracy for predicting SAE, with a cutoff ≥ 1.30 (AUC: 0.963, sensitivity 95.45%, specificity 100%). RI on day 3 was also highly predictive (AUC: 0.971, cutoff ≥ 0.67, sensitivity 95.45%, specificity 95.92%).

conclusionsIn this sample of septic patients, PI and RI are strong predictors of SAE, with PI serving as a reliable early indicator of both SAE and mortality. Trial Preregistration The study was registered in the Pan African Clinical Trials Registry: PACTR202410707982429, date: 7/10/2024.

Indexed as

Pulsatility indexResistive indexSepsisSepsis-associated encephalopathyTranscranial Doppler

Identifiers

PMID41396561
PMCPMC12705473

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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.