Evidence map›Paper›PMID 27316657›Full record

Observational studyInteractive cardiovascular and thoracic surgery2016

Association of nadir oxygen delivery on cardiopulmonary bypass with serum glial fibrillary acid protein levels in paediatric heart surgery patients.

J Trent Magruder, Narutoshi Hibino, Sarah Collica, Huaitao Zhang, H Lynn Harness, Eugenie S Heitmiller, Marshall L Jacobs, Duke E Cameron, Luca A Vricella, Allen D Everett

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Interactive cardiovascular and thoracic surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.7field-weighted citation impact, top 8% 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

7 citing papers in PubMed, 19 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

10 authors at 2 institutions in 1 country.

J Trent MagruderDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Narutoshi HibinoDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sarah CollicaDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Huaitao ZhangDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
H Lynn HarnessDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eugenie S HeitmillerDivision of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Marshall L JacobsDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Duke E CameronDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Luca A VricellaDivision of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Allen D EverettDivision of Pediatric Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA aeveret3@jhmi.edu.
Johns Hopkins Medicine · USJohns Hopkins University · US

Funding

Adult Biomarkers in Neonatal Brain Injury and DevelopmentR01HD086058 · NICHD · JOHNS HOPKINS UNIVERSITY · PI EVERETT, ALLEN D, NORTHINGTON, FRANCES J · 2016 to 2020
$3.1M
NICHD NIH HHS R01 HD086058
6 · The paper itself

Abstract

objectivesProtecting the brain during cardiac surgery is a major challenge. We evaluated associations between nadir oxygen delivery (DO2) during paediatric cardiac surgery and a biomarker of brain injury, glial fibrillary acidic protein (GFAP).

methodsBlood samples were obtained during a prospective, single-centre observational study of children undergoing congenital heart surgery with cardiopulmonary bypass (CPB) (2010-2011). Remnant blood samples, collected serially prior to cannulation for bypass and until incision closure, were analysed for GFAP levels. Perfusion records were reviewed to calculate nadir DO2. Linear regression analysis was used to assess the association between nadir DO2 and GFAP levels.

resultsA total of 116 consecutive children were included, with the median age of 0.75 years (interquartile range: 0.42-8.00) and the median weight of 8.3 kg (5.8-20.0). Single-ventricle anatomy was present in 19 patients (16.4%). Deep hypothermic circulatory arrest (DHCA) was used in 14 patients (12.1%). On univariable analysis, nadir DO2 was significantly associated with GFAP values measured during rewarming on CPB (P = 0.005) and after CPB decannulation (P = 0.02). On multivariable analysis controlling for CPB time, DHCA and procedure risk category, a significant negative relationship remained between nadir DO2 and post-CPB GFAP (P = 0.03).

conclusionsLower nadir DO2 is associated with increased GFAP levels, suggesting that diminished DO2 during paediatric heart surgery may be contributing to neurological injury. The DO2-GFAP relationship may provide a useful measure for the implementation of neuroprotective strategies in paediatric heart surgery, including goal-directed perfusion.

Indexed as

Cardiac Surgical ProceduresCardiopulmonary BypassOxygen Inhalation TherapyBiomarkersChildChild, PreschoolCirculatory Arrest, Deep Hypothermia InducedFemaleGlial Fibrillary Acidic ProteinHeart Defects, CongenitalHumansInfantMalePerfusionProspective StudiesRewarmingBiomarkersGlial Fibrillary Acidic ProteinBrain injuryCardiopulmonary bypassCongenital heart diseasePaediatric

Identifiers

PMID27316657
PMCPMC11616629
OpenAlexW2443833510

What OpenQuestion holds

Textmetadata
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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.