Evidence map›Paper›PMID 24671945›Full record

Trial reportCirculation2014

Tight glycemic control after pediatric cardiac surgery in high-risk patient populations: a secondary analysis of the safe pediatric euglycemia after cardiac surgery trial.

Michael S D Agus, Lisa A Asaro, Garry M Steil, Jamin L Alexander, Melanie Silverman, David Wypij, Michael G Gaies, SPECS Investigators

4 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
4.1field-weighted citation impact, top 6% 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.

NCT00443599 nacompletednot on this map

Maintaining Normal Blood Sugar Levels in Children Undergoing Heart Surgery to Reduce the Risk of Infections and Improve Recovery (The SPECS Study)

TypeinterventionalSponsorBoston Children's HospitalRan2006 to 2014Enrolled989ConditionsHeart Defects, Congenital, HyperglycemiaArmsInsulin, Usual Care
NCT02299479 nacompletednot on this mapstarted 2015, after this paper: background citation

Adjusting Insulin Delivery to Activity (AIDA)

TypeinterventionalSponsorBoston Children's HospitalRan2015 to 2017Enrolled20ConditionsDiabetes, Nocturnal HypoglycemiaArmsDexcom G4 Platinum CGM, Activity monitor
NCT02300285 naterminatednot on this mapstarted 2015, after this paper: background citation

Efficacy of Continuous Glucose Monitoring in Neonates With Hypoglycemia

TypeinterventionalSponsorBoston Children's HospitalRan2015 to 2018Enrolled6ConditionsHypoglycemia, Newborn MorbidityArmsContinuous Glucose Monitoring
NCT02806999 phase4unknown statusnot on this mapstarted 2016, after this paper: background citation

The Therapeutic Effects of Combination of Insulin With Berberine on the Patients With Stess Hyperlipemia:a Prospective, Double Blind, Randomized, Placebo-controlled, Single-center Clinical Trial

TypeinterventionalSponsorGuangdong Provincial People's HospitalRan2016 to 2017Enrolled200ConditionsHyperglycemiaArmsBerberine, Insulin, Insulin
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 43 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Tight Glycemic Control With Insulin Does Not Affect Skeletal Muscle Degradation During the Early Postoperative Period Following Pediatric Cardiac Surgery.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2015
    Trial
  4. Review
  5. Article
  6. Article
  7. Classifying Infection Risk Following Pediatric Cardiac Surgery.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2022
    Article
  8. Review
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Observational
  15. Review
  16. Pediatric Multiple Organ Dysfunction Syndrome: Promising Therapies.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2017
    Review
  17. Tight Glycemic Control in the Pediatric Intensive Care Unit.Journal of pediatric intensive care · 2016
    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

8 authors at 1 institution in 1 country.

Michael S D AgusFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.). michael.agus@childrens.harvard.edu.
Lisa A AsaroFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
Garry M SteilFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
Jamin L AlexanderFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
Melanie SilvermanFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
David WypijFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
Michael G GaiesFrom the Division of Medicine Critical Care (M.S.D.A., G.M.S., J.L.A., M.S.) and Department of Cardiology (L.A.A., D.W.), Boston Children's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.W.); and Division of Pediatric Cardiology, C.S. Mott Children's Hospital and University of Michigan Medical School, Ann Arbor (M.G.G.).
SPECS Investigators
Harvard University · US

Funding

WIRELESS CAPSULE ENDOSCOPY TO EVALUATE THE SMALL INTESTINE M01RR002172 · NCRR · CHILDREN'S HOSPITAL BOSTON · PI MANDELL, JAMES WILLIAM · 1985 to 2008
$16.0M
SPECS: Safe Pediatric Euglycemia in Cardiac SurgeryR01HL088448 · NHLBI · BOSTON CHILDREN'S HOSPITAL · PI AGUS, MICHAEL SD · 2007 to 2011
$4.0M
NCRR NIH HHS M01 RR002172NCRR NIH HHS M01-RR02172NHLBI NIH HHS R01 HL088448NHLBI NIH HHS R01HL088448NHLBI NIH HHS R01HL088448-02S1
6 · The paper itself

Abstract

backgroundOur previous randomized, clinical trial showed that postoperative tight glycemic control (TGC) for children undergoing cardiac surgery did not reduce the rate of health care-associated infections compared with standard care (STD). Heterogeneity of treatment effect may exist within this population. METHODS AND

resultsWe performed a post hoc exploratory analysis of 980 children from birth to 36 months of age at the time of cardiac surgery who were randomized to postoperative TGC or STD in the intensive care unit. Significant interactions were observed between treatment group and both neonate (age ≤30 days; P=0.03) and intraoperative glucocorticoid exposure (P=0.03) on the risk of infection. The rate and incidence of infections in subjects ≤60 days old were significantly increased in the TGC compared with the STD group (rate: 13.5 versus 3.7 infections per 1000 cardiac intensive care unit days, P=0.01; incidence: 13% versus 4%, P=0.02), whereas infections among those >60 days of age were significantly reduced in the TGC compared with the STD group (rate: 5.0 versus 14.1 infections per 1000 cardiac intensive care unit days, P=0.02; incidence: 2% versus 5%, P=0.03); the interaction of treatment group by age subgroup was highly significant (P=0.001). Multivariable logistic regression controlling for the main effects revealed that previous cardiac surgery, chromosomal anomaly, and delayed sternal closure were independently associated with increased risk of infection.

conclusionsThis exploratory analysis demonstrated that TGC may lower the risk of infection in children >60 days of age at the time of cardiac surgery compared with children receiving STD. Meta-analyses of past and ongoing clinical trials are necessary to confirm these findings before clinical practice is altered. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00443599.

Indexed as

Thoracic SurgeryBlood GlucoseChild, PreschoolHumansHyperglycemiaHypoglycemic AgentsIncidenceInfantInfant, NewbornInfectionsInsulinIntensive Care Units, PediatricPostoperative PeriodTreatment OutcomeBlood GlucoseHypoglycemic AgentsInsulinblood glucosecritical careheart diseaseshyperglycemiapediatrics

Identifiers

PMID24671945
PMCPMC4043858
OpenAlexW2103525675

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.