Evidence map›Paper›PMID 29336389›Full record

Trial reportAnnals of cardiac anaesthesia

A randomized controlled trial comparing the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass, assessed by changes in N-terminal brain natriuretic peptide.

Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah

Open access · diamondAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Annals of cardiac anaesthesia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
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

4 authors at 2 institutions in 1 country.

Balaji KuppuswamyDepartment of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Kirubakaran DavisDepartment of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Raj SahajanandanDepartment of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Manickam PonniahDepartment of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India.
Christian Medical College · INChristian Medical College & Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial.

settingChristian Medical College Hospital, Vellore, India.

participantsPatients undergoing elective coronary artery bypass surgery on CPB.

interventionAnesthesia was maintained with 0.8-1.2 end tidal concentrations of isoflurane in the isoflurane group and in the propofol group, anesthesia was maintained with propofol infusion as described by Roberts et al. MEASUREMENTS: Hemodynamic data were recorded at frequent intervals during the surgery and up to 24 h in the Intensive Care Unit (ICU). The other variables that were measured include duration of mechanical ventilation, dose and duration of inotropes in ICU, (inotrope score), duration of ICU stay, NT proBNP levels before induction and 24 h postoperatively, creatine kinase-MB levels in the immediate postoperative, first and second day.

resultsMean heart rate was significantly higher in propofol group during sternotomy, (P = 0.021). Propofol group had a significantly more number of patients requiring nitroglycerine in the prebypass period (P = 0.01). The increase in NT proBNP from preoperative to postoperative value was lesser in the isoflurane group compared to propofol even though the difference was not statistically significant. The requirement of phenylephrine to maintain mean arterial pressure within 20% of baseline, mechanical ventilation duration, inotrope use, duration of ICU stay and hospital stay were found to be similar in both groups.

conclusionPropofol exhibit comparable myocardial protective effect like that of isoflurane in patients undergoing coronary artery bypass graft surgery. Considering the unproven mortality benefit of isoflurane and the improved awareness of green OT concept, propofol may be the ideal alternative to volatile anesthetics, at least in patients with good left ventricular function.

Indexed as

Cardiopulmonary BypassElective Surgical ProceduresAgedCardiotonic AgentsCreatine Kinase, MB FormFemaleHemodynamicsHumansIsofluraneMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPropofolProspective StudiesCardiotonic AgentsCreatine Kinase, MB FormIsofluraneNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Propofol

Identifiers

PMID29336389
PMCPMC5791484
OpenAlexW2783043156

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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.