Evidence map›Paper›PMID 41857828›Full record

ArticleBMJ open2026

PRECISION study: impact of personalised cardiac anaesthesia and cerebral autoregulation on neurological outcomes in patients undergoing cardiac surgery - protocol for an international, multicentre, prospective cohort study.

Nuno V Gomes, Harry Edgar-Whelan, Erta Beqiri, Jim Young, Christian Schindler, Michael Gregor, Joachim M Erb, Martin Siegemund, Jens Kuhle, Aleksandra Maleska Maceski and 17 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05595954 (Impact of Personalised Cardiac Anaesthesia and Cerebral Autoregulation on Neurological Outcomes in Patients Undergoing Cardiac Surgery), 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.

NCT05595954 recruitingnot on this map

Impact of Personalised Cardiac Anaesthesia and Cerebral Autoregulation on Neurological Outcomes in Patients Undergoing Cardiac Surgery (PRECISION)

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2023 to 2027Enrolled500ConditionsPostoperative Delirium, Postoperative Stroke, Postoperative Cognitive DysfunctionArmsPreoperative data collection, Intraoperative NIRS, Intraoperative TCD, Intraoperative invasive MAP, Postoperative NIRS
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

27 authors.

Nuno V Gomes *Anesthesiology, University Hospital Basel, Basel, Switzerland nuno.gomes@usb.ch.ORCID http://orcid.org/0000-0001-5252-0073
Harry Edgar-Whelan *Department of Anaesthesia and Intensive Care, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Erta BeqiriBrain Physics Lab, Department of Clinical Neurosciences, Neurosurgery Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Jim YoungDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Christian SchindlerSwiss Tropical and Public Health Institute, Allschwil, Switzerland.ORCID http://orcid.org/0000-0003-3059-7613
Michael GregorAnesthesiology, University Hospital Basel, Basel, Switzerland.
Joachim M ErbAnesthesiology, University Hospital Basel, Basel, Switzerland.
Martin SiegemundDepartment of Clinical Research, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-2013-4140
Jens KuhleNeurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-6963-8892
Aleksandra Maleska MaceskiNeurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.
Edward NeedhamDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Sven CichonMedical Genetics, Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.
Bettina BurgerDepartment of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland.
Andreas U MonschFaculty of Psychology, University of Basel, Basel, Switzerland.
Wolfgang HasemannInstitute of Nursing Science, University of Basel, Basel, Switzerland.
Alexandra WüestMemory Clinic, University Department of Geriatric Medicine, Felix Platter Hospital, Basel, Switzerland.
Jens FasslDepartment of Cardiac Anesthesiology, Medical Faculty and Heart Center Dresden, TUD Dresden University of Technology, Dresden, Germany.
Heiko A KaiserDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Darren HightDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Anja LevisDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Dominik GünschDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
David K MenonDepartment of Medicine: Perioperative, Acute, Critical Care and Emergency Medicine (PACE) Section, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-3228-9692
Marek CzosnykaBrain Physics Lab, Department of Clinical Neurosciences, Neurosurgery Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Peter SmielewskiBrain Physics Lab, Department of Clinical Neurosciences, Neurosurgery Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Andrew A KleinDepartment of Anaesthesia and Intensive Care, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.ORCID http://orcid.org/0000-0001-9913-6570
Salome Dell-Kuster *Anesthesiology, University Hospital Basel, Basel, Switzerland.
Luzius A Steiner *Anesthesiology, University Hospital Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAdverse neurological complications, including postoperative delirium (POD) and stroke, remain one of the major risks after cardiac surgery. A lack of comprehensive knowledge about their causes and neuroprotective strategies has hindered the development of effective interventions to reduce these events. Personalised cerebral autoregulation (CA)-oriented blood pressure monitoring aims to identify blood pressure targets tailored to each individual patient, thereby reducing brain injury. The PRECISION study aims to assess whether perioperative duration and magnitude of mean arterial pressure (MAP) deviation from an individual's CA limits are associated with adverse neurological complications. METHODS AND ANALYSIS: This international, multicentre, prospective cohort study is conducted at two Swiss and one British hospital. Patients aged 65 years or older undergoing elective primary or re-operative coronary artery bypass graft and/or valvular and/or ascending aorta surgery requiring cardiopulmonary bypass are included. Preoperatively, the patient's baseline of physical, cognitive and mental status is established. Intraoperatively, near-infrared spectroscopy (NIRS) and transcranial Doppler (TCD) are recorded in real-time to generate NIRS-derived and TCD-derived CA indices. The primary endpoint is POD, assessed daily on postoperative days 0 to 7 or up to discharge, whichever occurs earlier with the 3D-Confusion Assessment Method (3D-CAM) or CAM-Intensive Care Unit. Secondary endpoints include a composite neurological outcome of POD and overt stroke, postoperative neurocognitive disorders, major morbidity and mortality. Associations between neurologic outcomes, neurobiomarkers and genetic variation will be explored.A total of 500 participants is required to achieve 90% power to find a statistically significant effect of the area under the curve MAP<lower limit of CA (LLA) on the risk of POD at the 5% level. This includes adjustment for potential confounders and for the inability to determine the LLA. ETHICS AND DISSEMINATION: Ethical approval has been obtained from all responsible ethics committees (Swiss lead ethics committee EKNZ 2022-01457 and Health Research Authority and Health and Care Research Wales, UK, REC 23/SW/0076). Results will be disseminated at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05595954.

Indexed as

Anesthesia, Cardiac ProceduresCardiac Surgical ProceduresCerebrovascular CirculationHomeostasisPostoperative ComplicationsStrokeAgedArterial PressureFemaleHumansMaleMulticenter Studies as TopicObservational Studies as TopicProspective StudiesResearch DesignSpectroscopy, Near-InfraredAdult anaesthesiaBrainCardiac surgeryNeurological injury

Identifiers

PMID41857828
PMCPMC13064205

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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.