Evidence map›Paper›PMID 26842716›Full record

Trial reportNeurocritical care2016

A Randomized Trial of Central Venous Catheter Type and Thrombosis in Critically Ill Neurologic Patients.

Jeffrey J Fletcher, Thomas J Wilson, Venkatakrishna Rajajee, William R Stetler, Teresa L Jacobs, Kyle M Sheehan, Devin L Brown

Abstract readComparative StudyRandomized Controlled TrialPragmatic Clinical Trial
PubMed Publisher
In one paragraph

Trial report in Neurocritical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
4.5field-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.

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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
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

7 authors at 1 institution in 1 country.

Jeffrey J FletcherDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA. jflet10121@aol.com.
Thomas J WilsonDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA.
Venkatakrishna RajajeeDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA.
William R StetlerDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA.
Teresa L JacobsDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA.
Kyle M SheehanDepartment of Neurosurgery, University of Michigan, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, MI, 48109-5338, USA.
Devin L BrownDepartment of Neurology, University of Michigan, Ann Arbor, MI, USA.
University of Michigan–Ann Arbor · US

Funding

MICHIGAN INSTITUTE FOR CLINICAL AND HEALTH RESEARCH (MICHR) (UL1): (BPCA)UL1RR024986 · NCRR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI SHANLEY, THOMAS P. · 2007 to 2011
$51.2M
NCRR NIH HHS UL1 RR024986
6 · The paper itself

Abstract

backgroundObservational studies suggest peripherally inserted central venous catheters (PICCs) are associated with a high risk of catheter-related large vein thrombosis (CRLVT) in critically ill neurologic patients. We evaluated the difference in thrombosis risk between PICCs and centrally inserted central venous catheters (CICVCs).

methodsWe conducted a pragmatic, randomized controlled trial of critically ill adult neurologic patients admitted to neurological and trauma critical care units at two level I trauma centers. Patients were randomized to receive either a PICC or CICVC and undergo active surveillance for CRLVT or death within 15 days of catheter placement.

resultsIn total, 39 subjects received a PICC and 41 received a CICVC between February 2012 and July 2015. The trial was stopped after enrollment of 80 subjects due to feasibility affected by slow enrollment and funding. In the primary intention-to-treat analysis, 17 (43.6 %) subjects that received a PICC compared to 9 (22.0 %) that received a CICVC experienced the composite of CRLVT or death, with a risk difference of 21.6 % (95 % CI 1.57-41.71 %). Adjusted common odds ratio of CRLVT/death was significantly higher among subjects randomized to receive a PICC (adjusted OR 3.08; 95 % CI 1.1-8.65). The higher adjusted odds ratio was driven by risk of CRLVT, which was higher in those randomized to PICC compared to CICVC (adjusted OR 4.66; 95 % CI 1.3-16.76) due to increased large vein thrombosis without a reduction in proximal deep venous thrombosis.

conclusionsOur trial demonstrates that critically ill neurologic patients who require a central venous catheter have significantly lower odds of ultrasound-diagnosed CRLVT with placement of a CICVC as compared to a PICC.

Indexed as

Outcome Assessment, Health CareAdultAgedCatheterization, Central VenousCatheterization, PeripheralCentral Venous CathetersCritical IllnessFemaleHumansMaleMiddle AgedNervous System DiseasesUpper Extremity Deep Vein ThrombosisVenous ThrombosisCentral venous cathetersUpper extremity deep venous thrombosisVascular access devicesVenous thrombosis

Identifiers

PMID26842716
OpenAlexW2282799106

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.