Evidence map›Paper›PMID 38280508›Full record

Observational studyResuscitation2024

Association between ASL MRI-derived cerebral blood flow and outcomes after pediatric cardiac arrest.

Matthew P Kirschen, Minhui Ouyang, Bhavesh Patel, Jeffrey I Berman, Ryan Burnett, Robert A Berg, Ramon Diaz-Arrastia, Alexis Topjian, Hao Huang, Arastoo Vossough

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Resuscitation, 2024. 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
1.4field-weighted citation impact, top 22% of its field
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, 2 citations in OpenAlex.

  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

10 authors at 2 institutions in 1 country.

Matthew P KirschenDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: kirschenm@chop.edu.
Minhui OuyangDepartment of Radiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Bhavesh PatelDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Jeffrey I BermanDepartment of Radiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Ryan BurnettDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Robert A BergDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Ramon Diaz-ArrastiaDepartment of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Alexis TopjianDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Hao HuangDepartment of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Arastoo VossoughDepartment of Radiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Children's Hospital of Philadelphia · USUniversity of Pennsylvania · US

Funding

The Intellectual and Developmental Disabilities Research Center (IDDRC) at CHOP/PennP50HD105354 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI ERIC D MARSH, ROBERT Thomas SCHULTZ · 2021 to 2026
$9.2M
Structural Development of Human Fetal BrainR01MH092535 · NIMH · UT SOUTHWESTERN MEDICAL CENTER · PI HUANG, HAO · 2011 to 2020
$4.6M
Infant Atlas of Brain PerfusionR01EB031284 · NIBIB · CHILDREN'S HOSP OF PHILADELPHIA · PI HUANG, HAO · 2021 to 2025
$2.4M
Cerebral autoregulation and MRI measures of brain injury after pediatric-post cardiac arrestK23NS116120 · NINDS · CHILDREN'S HOSP OF PHILADELPHIA · PI KIRSCHEN, MATTHEW P · 2021 to 2025
$966k
NIBIB NIH HHS R01 EB031284NICHD NIH HHS P50 HD105354NIMH NIH HHS R01 MH092535NINDS NIH HHS K23 NS116120
6 · The paper itself

Abstract

aimCerebral blood flow (CBF) is dysregulated after cardiac arrest. It is unknown if post-arrest CBF is associated with outcome. We aimed to determine the association of CBF derived from arterial spin labelling (ASL) MRI with outcome after pediatric cardiac arrest.

methodsRetrospective observational study of patients ≤18 years who had a clinically obtained brain MRI within 7 days of cardiac arrest between June 2005 and December 2019. Primary outcome was unfavorable neurologic status: change in Pediatric Cerebral Performance Category (PCPC) ≥1 from pre-arrest that resulted in hospital discharge PCPC 3-6. We measured CBF in whole brain and regions of interest (ROIs) including frontal, parietal, and temporal cortex, caudate, putamen, thalamus, and brainstem using pulsed ASL. We compared CBF between outcome groups using Wilcoxon Rank-Sum and performed logistic regression to associate each region's CBF with outcome, accounting for age, sex, and time between arrest and MRI.

resultsForty-eight patients were analyzed (median age 2.8 [IQR 0.95, 8.8] years, 65% male). Sixty-nine percent had unfavorable outcome. Time from arrest to MRI was 4 [3,5] days and similar between outcome groups (p = 0.39). Whole brain median CBF was greater for unfavorable compared to favorable groups (28.3 [20.9,33.0] vs. 19.6 [15.3,23.1] ml/100 g/min, p = 0.007), as was CBF in individual ROIs. Greater CBF in the whole brain and individual ROIs was associated with higher odds of unfavorable outcome after controlling for age, sex, and days from arrest to MRI (aOR for whole brain 19.08 [95% CI 1.94, 187.41]).

conclusionCBF measured 3-5 days after pediatric cardiac arrest by ASL MRI was independently associated with unfavorable outcome.

Indexed as

Heart ArrestMagnetic Resonance ImagingBrainCerebrovascular CirculationChildChild, PreschoolFemaleHumansMaleSpin LabelsSpin LabelsArterial spin labelingMRINeuroimagingPediatric cardiac arrest

Identifiers

PMID38280508
PMCPMC10923119
OpenAlexW4391256316

What Socratic holds

Textmetadata
LicenceTDM
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 Socratic graph.