Evidence map›Paper›PMID 27686343›Full record

Trial reportIntensive care medicine2016

Nitric oxide administration during paediatric cardiopulmonary bypass: a randomised controlled trial.

Christopher James, Johnny Millar, Stephen Horton, Christian Brizard, Charlotte Molesworth, Warwick Butt

3 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 48 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 3 pooled it
12.0field-weighted citation impact, top 1% 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.

NCT03455218 phase2 / phase3completednot on this mapstarted 2018, after this paper: background citation

Nitric Oxide Administration During Pediatric Cardiopulmonary Bypass Surgery to Prevent Platelet activation-a Single Center Pilot Study

TypeinterventionalSponsorMedical College of WisconsinRan2018 to 2019Enrolled40ConditionsInflammation, Platelet DysfunctionArmsNitric Oxide, Placebo, INOmax
NCT03661385 phase3completednot on this mapstarted 2018, after this paper: background citation

A Randomised Controlled Trial of Nitric Oxide Administration During Cardiopulmonary Bypass in Infants Undergoing Arterial Switch Operation for Repair of Transposition of the Great Arteries

TypeinterventionalSponsorMurdoch Childrens Research InstituteRan2018 to 2023Enrolled300ConditionsLow Cardiac Output Syndrome, Transposition of Great VesselsArmsNitric Oxide
NCT04997291 phase1unknown statusnot on this mapstarted 2021, after this paper: background citation

Use of the Cardioprotectant Dexrazoxane During Congenital Heart Surgery

TypeinterventionalSponsorUniversity of Texas at AustinRan2021 to 2022Enrolled12ConditionsHeart Defects, CongenitalArmsDexrazoxane
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 102 citations in OpenAlex.

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  13. NO Addition during Gas Oxygenation Reduces Liver and Kidney Injury during Prolonged Cardiopulmonary Bypass.Pathophysiology : the official journal of the International Society for Pathophysiology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Christopher JamesDepartment of Intensive Care, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia. Christopher.James@rch.org.au.ORCID http://orcid.org/0000-0002-8742-1419
Johnny MillarDepartment of Intensive Care, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia.
Stephen HortonMurdoch Children's Research Institute, Melbourne, Australia.
Christian BrizardDepartment of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.
Charlotte MolesworthMurdoch Children's Research Institute, Melbourne, Australia.
Warwick ButtDepartment of Intensive Care, Royal Children's Hospital, 50 Flemington Road, Parkville, Melbourne, VIC, 3052, Australia.
Royal Children's Hospital · AUMurdoch Children's Research Institute · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCardiopulmonary bypass induces an ischaemia-reperfusion injury and systemic inflammatory response, which contributes to low cardiac output syndrome following cardiac surgery. Exogenous nitric oxide during cardiopulmonary bypass has shown potential to ameliorate such injury. We undertook a large randomised controlled trial to investigate the clinical effects of administering nitric oxide to the cardiopulmonary bypass circuit in children.

methodsAfter written informed consent, children were randomised to receive 20 ppm nitric oxide to the gas inflow of the cardiopulmonary bypass oxygenator, or standard conduct of bypass.

results101 children received nitric oxide and developed low cardiac output syndrome less frequently (15 vs. 31 %, p = 0.007) than the 97 children who did not receive nitric oxide. This effect was most marked in children aged less than 6 weeks of age (20 vs. 52 %, p = 0.012) and in those aged 6 weeks to 2 years (6 vs. 24 %, p = 0.026), who also had significantly reduced ICU length of stay (43 vs. 84 h, p = 0.031). Low cardiac output syndrome was less frequent following more complex surgeries if nitric oxide was administered (17 vs. 48 %, p = 0.018). ECMO was used less often in the nitric oxide group (1 vs. 8 %, p = 0.014).

conclusionsDelivery of nitric oxide to the oxygenator gas flow during paediatric cardiopulmonary bypass reduced the incidence of low cardiac output syndrome by varying degrees, according to age group and surgery complexity. CLINICAL

trial registrationACTRN12615001376538.

Indexed as

Age FactorsCardiac Output, LowCardiopulmonary BypassChild, PreschoolChi-Square DistributionFemaleHumansInfantMaleNitric OxideReperfusion InjurySingle-Blind MethodStatistics, NonparametricSystemic Inflammatory Response SyndromeNitric OxideCardiopulmonary bypassCongenital heart diseaseLow cardiac output syndromeNitric oxide

Identifiers

PMID27686343
OpenAlexW2509344077

What OpenQuestion holds

Textmetadata
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.