Evidence map›Paper›PMID 26700606›Full record

ArticleJournal of critical care2016

Prolonged postoperative respiratory support after proximal thoracic aortic surgery: Is deep hypothermic circulatory arrest a risk factor?

Matthew A Schechter, Asad A Shah, Brian R Englum, Judson B Williams, Asvin M Ganapathi, John D Davies, Ian J Welsby, G Chad Hughes

Abstract read
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In one paragraph

Article in Journal of critical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.2field-weighted citation impact, top 19% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 20 citations in OpenAlex.

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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 2 institutions in 1 country.

Matthew A SchechterDepartment of Surgery, Duke University Medical Center, Durham, NC.
Asad A ShahDepartment of Surgery, Duke University Medical Center, Durham, NC.
Brian R EnglumDepartment of Surgery, Duke University Medical Center, Durham, NC.
Judson B WilliamsDepartment of Surgery, Duke University Medical Center, Durham, NC.
Asvin M GanapathiDepartment of Surgery, Duke University Medical Center, Durham, NC.
John D DaviesDepartment of Respiratory Services, Duke University Medical Center, Durham, NC.
Ian J WelsbyDepartment of Anesthesia, Duke University Medical Center, Durham, NC.
G Chad HughesDepartment of Surgery, Duke University Medical Center, Durham, NC. Electronic address: gchad.hughes@duke.edu.
Duke Medical Center · USDuke University Hospital · US

Funding

Cardiothoracic Surgical Network Clinical CenterU01HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2007 to 2013
$2.6M
Core Clinical Centers for the CTSNUM1HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2013 to 2017
$2.5M
NHLBI NIH HHS U01 HL088953NHLBI NIH HHS UM1 HL088953
6 · The paper itself

Abstract

purposeIn addition to the pulmonary risks associated with cardiopulmonary bypass, thoracic aortic surgery using deep hypothermic circulatory arrest (DHCA) may subject the lungs to further injury. However, this topic has received little investigation to date. MATERIALS AND

methodsA prospective cohort review was performed on all patients undergoing proximal thoracic aortic surgery with (n = 478) and without (n = 135) DHCA between July 2005 and February 2013 at a single institution. The primary outcome was prolonged postoperative respiratory support (PPRS), defined as any of the following: >1 day of mechanical ventilation at either fraction of inspired oxygen >0.4 and/or positive end-expiratory pressure >5 mm Hg, >2 days of supplemental O2 requirement of at least 2.5 L/min, or discharge with new O2 requirement. Independent risk factors for PPRS were identified using multivariable logistic regression.

resultsPostoperative respiratory support was required in 100 patients (20.9%) with and 30 patients (22.2%) without DHCA (P = .74). Independent predictors of PPRS after proximal aortic surgery included the following: age, diabetes, history of stroke, preoperative creatinine, American Society of Anesthesiologists class 4, redo-sternotomy, total arch replacement, and transfusion requirement. Use of DHCA was not an independent risk factor for PPRS in the entire cohort. Subanalysis of only DHCA patients revealed that longer DHCA times were independently associated with PPRS.

conclusionsProlonged postoperative respiratory support is common after proximal aortic surgery. The use of DHCA was not associated with this complication in the overall cohort, although longer DHCA times were predictive when only the subset of patients undergoing DHCA was analyzed. Knowledge of the risk factors for PPRS after proximal aortic surgery should improve preoperative risk stratification and postoperative management of these patients.

Indexed as

AdultAgedAorta, ThoracicCardiopulmonary BypassCirculatory Arrest, Deep Hypothermia InducedFemaleHumansLogistic ModelsMaleMiddle AgedOxygen Inhalation TherapyPostoperative PeriodProspective StudiesRespiration, ArtificialRetrospective StudiesRisk FactorsAortaCirculatory arrestDeep hypothermia inducedRespirationRisk factorsThoracic surgical procedures

Identifiers

PMID26700606
PMCPMC5142518
OpenAlexW2194712774

What OpenQuestion holds

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Registered trials

None linked

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.