{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:16:11Z","timestamp":1789067771791,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T00:00:00Z","timestamp":1714867200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005423","name":"Uppsala University Hospital","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100005423","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>Background: Cerebral perfusion pressure (CPP) is an important target in aneurysmal subarachnoid hemorrhage (aSAH), but it does not take into account autoregulatory disturbances. The pressure reactivity index (PRx) and the CPP with the optimal PRx (CPPopt) are new variables that may capture these pathomechanisms. In this study, we investigated the effect on the outcome of certain combinations of CPP or \u0394CPPopt (actual CPP-CPPopt) with the concurrent autoregulatory status (PRx) after aSAH. Methods: This observational study included 432 aSAH patients, treated in the neurointensive care unit, at Uppsala University Hospital, Sweden. Functional outcome (GOS-E) was assessed 1-year postictus. Heatmaps of the percentage of good monitoring time (%GMT) of PRx\/CPP and PRx\/\u0394CPPopt combinations in relation to GOS-E were created to visualize the association between these variables and outcome. Results: In the heatmap of the %GMT of PRx\/CPP, the combination of lower CPP with higher PRx values was more strongly associated with lower GOS-E. The tolerance for lower CPP values increased with lower PRx values until a threshold of \u22120.50. However, for decreasing PRx below \u22120.50, there was a gradual reduction in the tolerance for lower CPP. In the heatmap of the %GMT of PRx\/\u0394CPPopt, the combination of negative \u0394CPPopt with higher PRx values was strongly associated with lower GOS-E. In particular, negative \u0394CPPopt together with PRx above +0.50 correlated with worse outcomes. In addition, there was a transition toward an unfavorable outcome when PRx went below \u22120.50, particularly if \u0394CPPopt was negative. Conclusions: The PRx levels influenced the association between CPP\/\u0394CPPopt and outcome. Thus, this variable could be used to individualize a safe CPP-\/\u0394CPPopt-range.<\/jats:p>","DOI":"10.1177\/08850666241252415","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T01:52:55Z","timestamp":1714960375000},"page":"1083-1092","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Individualized Autoregulation-Derived Cerebral Perfusion Targets in Aneurysmal Subarachnoid Hemorrhage: A New Therapeutic Avenue?"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4556-5721","authenticated-orcid":false,"given":"Teodor Mikael","family":"Svedung Wettervik","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9369-3886","authenticated-orcid":false,"given":"Anders","family":"H\u00e5nell","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Howells","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Ronne-Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Lew\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Enblad","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,5]]},"reference":[{"key":"bibr1-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/2022.5.JNS22560"},{"key":"bibr2-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.688362"},{"key":"bibr3-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-020-01162-4"},{"key":"bibr4-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199707000-00005"},{"key":"bibr5-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200204000-00002"},{"key":"bibr6-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182514eb6"},{"key":"bibr7-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.11.027"},{"key":"bibr8-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-023-01741-1"},{"key":"bibr9-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181d45530"},{"key":"bibr10-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7290"},{"key":"bibr11-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.6157"},{"key":"bibr12-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01496-1"},{"key":"bibr13-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040339"},{"key":"bibr14-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/2022.5.JNS22560"},{"key":"bibr15-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000298898.38979.E3"},{"key":"bibr16-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/2019.11.JNS192759"},{"key":"bibr17-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.1998.15.587"},{"key":"bibr18-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.1998.15.573"},{"key":"bibr19-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2005.102.2.0311"},{"key":"bibr20-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04485-8"},{"key":"bibr21-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002575"},{"key":"bibr22-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2021.0197"},{"key":"bibr23-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2023.0017"},{"key":"bibr24-08850666241252415","volume-title":"R: A language and environment for statistical computing","author":"(2021) RCT","year":"2023"},{"key":"bibr25-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.596874"},{"key":"bibr26-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1997.87.1.0009"},{"key":"bibr27-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003016"},{"key":"bibr28-08850666241252415","doi-asserted-by":"publisher","DOI":"10.3171\/2012.1.JNS111313"},{"key":"bibr29-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-009-9287-8"},{"key":"bibr30-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1016\/j.wnsx.2023.100160"},{"key":"bibr31-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5003"},{"key":"bibr32-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-016-9863-3"},{"key":"bibr33-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0107-z"},{"key":"bibr34-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6726"},{"key":"bibr35-08850666241252415","doi-asserted-by":"publisher","DOI":"10.1186\/s40635-023-00524-4"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666241252415","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08850666241252415","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08850666241252415","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:58:03Z","timestamp":1777503483000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08850666241252415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,5]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1177\/08850666241252415"],"URL":"https:\/\/doi.org\/10.1177\/08850666241252415","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,5]]}}}