Evidence map›Paper›PMID 41618390›Full record

ArticleCost effectiveness and resource allocation : C/E2026

Impact of hemodynamic management guided by intracranial compliance on the outcome of critically ill patients - preliminary results and exploratory economic evaluation.

Carlos Eduardo Nassif Moreira, Celso Madeira Padovesi, Vivian Vieira Tenório Sales, Patrícia Junqueira Freitas Holdack, Marcia Maria Deutscher Furlan, Marcos Soares Tavares, Marcelo Tadeu Carnielo, André de Macedo Bianco

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Article in Cost effectiveness and resource allocation : C/E, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Carlos Eduardo Nassif MoreiraHospital Nove de Julho, Sao Paulo, SP, Brazil. cenm65@terra.com.br.
Celso Madeira PadovesiHospital Nove de Julho, Sao Paulo, SP, Brazil.
Vivian Vieira Tenório SalesHospital Nove de Julho, Sao Paulo, SP, Brazil.
Patrícia Junqueira Freitas HoldackHospital Nove de Julho, Sao Paulo, SP, Brazil.
Marcia Maria Deutscher FurlanHospital Nove de Julho, Sao Paulo, SP, Brazil.
Marcos Soares TavaresHospital Nove de Julho, Sao Paulo, SP, Brazil.
Marcelo Tadeu CarnieloPlanisa Planejamento e Organização de Instituição de Saúde, Sao Paulo, SP, Brazil.
André de Macedo BiancoHospital Nove de Julho, Sao Paulo, SP, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimization of cerebral perfusion through individualized hemodynamic strategies has emerged as a relevant strategy in critical care. The brain4care (B4C) System offers a non-invasive method to monitor intracranial compliance (ICC) via the P2/P1 ratio, a marker of intracranial dynamics. This study evaluated the impact of ICC-guided management on clinical and economic outcomes.

methodsThis retrospective observational study included 102 critically ill patients at the Intensive Care Unit (ICU) of Nove de Julho Hospital, São Paulo, Brazil. Fifty-one patients underwent ICC-guided mean arterial pressure (MAP) management using the B4C System; 51 received standard care. The primary outcome was ICU mortality. Secondary outcomes included 30-day readmission, ICU and total hospital length of stay (LOS), discharge disposition, and Glasgow Coma Scale at discharge. Exploratory outcomes included hospital-perspective cost consequences based on LOS and readmissions.

resultsICC-guided management was associated with lower ICU mortality (5.88% vs. 37.25%, p = 0.0003) and fewer 30-day readmissions (12.50% vs. 38.70%, p = 0.014). ICU and total hospital LOS did not differ significantly between groups. Discharge home was more frequent in the ICC-guided group (58.8% vs. 27.5%). In an exploratory hospital-perspective cost-consequence analysis, readmission-related savings were estimated at USD $3,878 per patient, and LOS-related cost differences were reported as unit-cost impacts and interpreted cautiously given non-significant LOS differences.

conclusionICC-guided MAP management supported by the B4C System was associated with lower ICU mortality, fewer readmissions, and lower estimated costs. Prospective multicenter studies are needed to confirm these findings.

Indexed as

Cost-effectivenessHemodynamic managementIntracranial complianceNon-invasive monitoring

Identifiers

PMID41618390
PMCPMC12930840

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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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 Socratic graph.