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The principal goal of intensive care management is to detect and prevent further cerebral blood flow deficits. This can be achieved by actively managing cerebral perfusion pressure (CPP) using input from cerebrovascular autoregulation (CAR). The main objective of the current study was to investigate CAR after cardiac arrest in children.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Nineteen consecutive children younger than 18\u00a0years after cardiopulmonary resuscitation, in whom intracranial pressure (ICP) was continuously measured, were included. Blood pressure and ICP were continuously monitored via ICM\u2009+\u2009software and actively managed using the pressure reactivity index (PRx) to achieve and maintain an optimal CPP. Outcome was scored using the extended Glasgow outcome scale (eGOS) at discharge and 6\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eight children died in hospital. At 6\u00a0months, further 4 children had an unfavorable (eGOS1\u20134) and 7 a favorable (eGOS5\u20138) outcome. Over the entire monitoring period, we found an elevated ICP (24.5 vs 7.4\u00a0mmHg), a lower CPP (50.3 vs 66.2\u00a0mmHg) and a higher PRx (0.24 vs\u2009\u2212\u20090.01), indicating impaired CAR, in patients with unfavorable outcome. The dose of impaired autoregulation was significantly higher in unfavorable outcome (54.6 vs 29.3%). Analyzing only the first 72\u00a0h after cardiac arrest, ICP\u2009\u2265\u200910\u00a0mmHg and PRx\u2009&gt;\u20090.2 correlated to unfavorable outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Significant doses of impaired CAR within 72\u00a0h after resuscitation are associated with unfavorable outcome. The inability to restore autoregulation despite active attempts to do so as well as an elevated ICP may serve as a bad prognostic sign indicating a severe initial hypoxic-ischemic brain injury.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00381-022-05579-4","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T18:03:45Z","timestamp":1654797825000},"page":"1717-1726","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Monitoring of cerebrovascular pressure reactivity in children may predict neurologic outcome after hypoxic-ischemic brain injury"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4725-713X","authenticated-orcid":false,"given":"Julian","family":"Zipfel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Hegele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Hockel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne R.","family":"Kerscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Heimberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Czosnyka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Neunhoeffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"5579_CR1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/S1474-4422(20)30117-4","volume":"19","author":"T Cronberg","year":"2020","unstructured":"Cronberg T, Greer DM, Lilja G, Moulaert V, Swindell P, Rossetti AO (2020) Brain injury after cardiac arrest: from prognostication of comatose patients to rehabilitation. 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