Evidence map›Paper›PMID 29208663›Full record

ArticleArchives of disease in childhood. Fetal and neonatal edition2018

Haemodynamic effects of umbilical cord milking in premature sheep during the neonatal transition.

Douglas A Blank, Graeme R Polglase, Martin Kluckow, Andrew William Gill, Kelly J Crossley, Alison Moxham, Karyn Rodgers, Valerie Zahra, Ishmael Inocencio, Fiona Stenning and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of disease in childhood. Fetal and neonatal edition, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 5 pooled it
9.6field-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.

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

53 citing papers in PubMed, 5 syntheses or guidelines pooled it, 102 citations in OpenAlex.

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  14. The effect of umbilical cord milking on cerebral blood flow in very preterm infants: a randomized controlled study.Journal of perinatology : official journal of the California Perinatal Association · 2021
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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

13 authors at 6 institutions in 2 countries.

Douglas A BlankNewborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia.
Graeme R PolglaseThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Martin KluckowDepartment of Neonatology, Royal North Shore Hospital and University of Sydney, New South Wales, Australia.
Andrew William GillCentre for Neonatal Research and Education, University of Western Australia, Perth, Australia.
Kelly J CrossleyThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Alison MoxhamThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Karyn RodgersThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Valerie ZahraThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Ishmael InocencioThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Fiona StenningThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Domeic A LaRosaThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Peter G DavisNewborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia.
Stuart B HooperThe Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia.
Hudson Institute of Medical Research · AUMonash University · AURoyal North Shore Hospital · AURoyal Ottawa Mental Health Centre · CARoyal Women's Hospital · AUUniversity of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveUmbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical cord clamping (UCC) and physiological-based cord clamping (PBCC) in preterm lambs.

methodsAt 126 days' gestational age, fetal lambs were exteriorised, intubated and instrumented to measure umbilical, pulmonary and cerebral blood flows and arterial pressures. Lambs received either (1) UCM without placental refill (UCMwoPR); (2) UCM with placental refill (UCMwPR); (3) PBCC, whereby ventilation commenced prior to UCC; or (4) immediate UCC. UCM involved eight milks along a 10 cm length of cord, followed by UCC.

resultsA net volume of blood was transferred into the lamb during UCMwPR (8.8 mL/kg, IQR 8-10, P=0.01) but not during UCMwoPR (0 mL/kg, IQR -2.8 to 1.7) or PBCC (1.1 mL/kg, IQR -1.3 to 4.3). UCM had no effect on pulmonary blood flow, but caused large fluctuations in mean carotid artery pressures (MBP) and blood flows (CABF). In UCMwoPR and UCMwPR lambs, MBP increased by 12%±1% and 8%±1% and CABF increased by 32%±2% and 15%±2%, respectively, with each milk. Cerebral oxygenation decreased the least in PBCC lambs (17%, IQR 13-26) compared with UCMwoPR (26%, IQR 23-25, P=0.03), UCMwPR (35%, IQR 27-44, P=0.02) and immediate UCC (34%, IQR 28-41, P=0.02) lambs.

conclusionsUCMwoPR failed to provide placental transfusion, and UCM strategies caused considerable haemodynamic disturbance. UCM does not provide the same physiological benefits of PBCC. Further review of UCM is warranted before adoption into routine clinical practice.

Indexed as

AnimalsAnimals, NewbornArterial PressureCerebrovascular CirculationConstrictionFemaleHemodynamicsPregnancyPremature BirthPulmonary CirculationSheepUmbilical CordVentilationdelayed cord clampingfetal medicineneonatologyprematureumbilical cord milking

Identifiers

PMID29208663
PMCPMC6278653
OpenAlexW2775574009

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.