Trial reportPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2014
Acetaminophen attenuates lipid peroxidation in children undergoing cardiopulmonary bypass.
Trial report in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04882202 (Effect of Acetaminophen on the Incidence of Acute Kidney Injury in Patients Undergoing Aortic Surgery With Moderate Hypothermic Circulatory Arrest), which is not on this map. Cited by 20 papers, 3 of them syntheses that pooled 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.
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.
Effect of Acetaminophen on the Incidence of Acute Kidney Injury in Patients Undergoing Aortic Surgery With Moderate Hypothermic Circulatory Arrest
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- The Role of Acetaminophen Use in Acute Kidney Injury Prevention in Cardiac Surgery: A Systematic Review and Meta-Analysis.Annals of cardiac anaesthesia · 2025Pooled it
- Hemolysis and cardiopulmonary bypass: meta-analysis and systematic review of contributing factors.Journal of cardiothoracic surgery · 2023Pooled it
- Strategies to Prevent Acute Kidney Injury after Pediatric Cardiac Surgery: A Network Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2021Pooled it
- Trial
- Preventing pediatric acute kidney injury: is it even possible?Pediatric nephrology (Berlin, Germany) · 2026Review
- Acute Kidney Injury after Cardiac Surgery: Prediction, Prevention, and Management.Anesthesiology · 2023Review
- Paracetamol use and lowered risk of acute kidney injury in patients with rhabdomyolysis.Journal of nephrology · 2021Article
- The Cross-Link between Ferroptosis and Kidney Diseases.Oxidative medicine and cellular longevity · 2021Review
- The Role of Circulating Cell-Free Hemoglobin in Sepsis-Associated Acute Kidney Injury.Seminars in nephrology · 2020Review
- Acute Kidney Injury and Fluid Overload in Pediatric Cardiac Surgery.Current treatment options in pediatrics · 2019Article
- Pharmacological interventions for the prevention of acute kidney injury after pediatric cardiac surgery: a network meta-analysis.Clinical and experimental nephrology · 2019Article
- Quantitation of paracetamol by liquid chromatography-mass spectrometry in human plasma in support of clinical trial.Future science OA · 2018Article
- Association Between Early Postoperative Acetaminophen Exposure and Acute Kidney Injury in Pediatric Patients Undergoing Cardiac Surgery.JAMA pediatrics · 2018Article
- Article
- Pyridoxamine reduces postinjury fibrosis and improves functional recovery after acute kidney injury.American journal of physiology. Renal physiology · 2016Article
- Acute kidney injury following cardiac surgery: current understanding and future directions.Critical care (London, England) · 2016Review
- Oxidative Stress after Surgery on the Immature Heart.Oxidative medicine and cellular longevity · 2016Review
- The isoprostanes--25 years later.Biochimica et biophysica acta · 2015Review
- The role of red blood cells and cell-free hemoglobin in the pathogenesis of ARDS.Journal of intensive care · 2015Review
- Nonopioid analgesics for perioperative and cardiac surgery pain in children: Current evidence and knowledge gaps.Annals of pediatric cardiologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveHemolysis, occurring during cardiopulmonary bypass, is associated with lipid peroxidation and postoperative acute kidney injury. Acetaminophen inhibits lipid peroxidation catalyzed by hemeproteins and in an animal model attenuated rhabdomyolysis-induced acute kidney injury. This pilot study tests the hypothesis that acetaminophen attenuates lipid peroxidation in children undergoing cardiopulmonary bypass.
designSingle-center prospective randomized double-blinded study.
settingUniversity-affiliated pediatric hospital. PATIENTS: Thirty children undergoing elective surgical correction of a congenital heart defect.
interventionsPatients were randomized to acetaminophen (OFIRMEV [acetaminophen] injection; Cadence Pharmaceuticals, San Diego, CA) or placebo every 6 hours for four doses starting before the onset of cardiopulmonary bypass. MEASUREMENT AND MAIN
resultsMarkers of hemolysis, lipid peroxidation (isofurans and F2-isoprostanes), and acute kidney injury were measured throughout the perioperative period. Cardiopulmonary bypass was associated with a significant increase in free hemoglobin (from a prebypass level of 9.8 ± 6.2 mg/dL to a peak of 201.5 ± 42.6 mg/dL postbypass). Plasma and urine isofuran and F2-isoprostane concentrations increased significantly during surgery. The magnitude of increase in plasma isofurans was greater than the magnitude in increase in plasma F2-isoprostanes. Acetaminophen attenuated the increase in plasma isofurans compared with placebo (p = 0.02 for effect of study drug). There was no significant effect of acetaminophen on plasma F2-isoprostanes or urinary makers of lipid peroxidation. Acetaminophen did not affect postoperative creatinine, urinary neutrophil gelatinase-associated lipocalin, or prevalence of acute kidney injury.
conclusionCardiopulmonary bypass in children is associated with hemolysis and lipid peroxidation. Acetaminophen attenuated the increase in plasma isofuran concentrations. Future studies are needed to establish whether other therapies that attenuate or prevent the effects of free hemoglobin result in more effective inhibition of lipid peroxidation in patients undergoing cardiopulmonary bypass.
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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.