Evidence map›Paper›PMID 29339351›Full record

Trial reportCirculation2018

High-Target Versus Low-Target Blood Pressure Management During Cardiopulmonary Bypass to Prevent Cerebral Injury in Cardiac Surgery Patients: A Randomized Controlled Trial.

Anne G Vedel, Frederik Holmgaard, Lars S Rasmussen, Annika Langkilde, Olaf B Paulson, Theis Lange, Carsten Thomsen, Peter Skov Olsen, Hanne Berg Ravn, Jens C Nilsson

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

Trial report in Circulation, 2018. 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 67 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 8 pooled it
21.5field-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.

NCT00981474 nacompletednot on this map

Continuous Cerebral Autoregulation Monitoring to Reduce Brain Injury From Cardiac Surgery

TypeinterventionalSponsorNorthwestern UniversityRan2009 to 2020Enrolled460ConditionsThoracic Surgery, Cardiopulmonary BypassArmsblood pressure maintenance based on cerebral blood flow autoregulation measurement, Control group
NCT02185885 nacompletednot on this map

The Importance of Mean Arterial Pressure During Cardiopulmonary Bypass to Prevent Cerebral Complications After Cardiac Surgery - a Randomised Clinical Trial.

TypeinterventionalSponsorRigshospitalet, DenmarkRan2014 to 2016Enrolled197ConditionsEmbolic Stroke, Postoperative Cognitive DysfunctionArmsIncreased bloodpressure during CPB.
NCT05740397 narecruitingnot on this mapstarted 2021, after this paper: background citation

Mean Arterial Pressure (MAP) Trial: Study Protocol for a Multicenter, Randomized, Controlled Trial to Compare Three Different Strategies of Mean Arterial Pressure Management During Cardiopulmonary By-pass

TypeinterventionalSponsorAzienda Ospedaliera Universitaria Integrata VeronaRan2021 to 2026Enrolled900ConditionsHeart, Surgery, Heart, Functional Disturbance as ResultArmsManagement of mean arterial pressure during cardiopulmonary by-pass in cardiac surgery interventions. The MAP will be mantained in the range of values of each study arm
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 8 syntheses or guidelines pooled it, 179 citations in OpenAlex.

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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Anne G VedelDepartment of Cardiothoracic Anesthesia, The Heart Center (A.G.V., F.H., H.B.R., J.C.N.) ppci@vedel.dk.
Frederik HolmgaardDepartment of Cardiothoracic Anesthesia, The Heart Center (A.G.V., F.H., H.B.R., J.C.N.).
Lars S RasmussenDepartment of Anesthesia, Center of Head and Orthopedics (L.S.R.).
Annika LangkildeDepartment of Radiology, Diagnostic Center (A.L., C.T.).
Olaf B PaulsonNeurobiological Research Unit, The Neuro Center (O.B.P.).
Theis LangeRigshospitalet, and Department of Biostatistics (T.L.), University of Copenhagen, Denmark.
Carsten ThomsenDepartment of Radiology, Diagnostic Center (A.L., C.T.).
Peter Skov OlsenDepartment of Cardiothoracic Surgery, The Heart Center (P.S.O.).
Hanne Berg RavnDepartment of Cardiothoracic Anesthesia, The Heart Center (A.G.V., F.H., H.B.R., J.C.N.).
Jens C NilssonDepartment of Cardiothoracic Anesthesia, The Heart Center (A.G.V., F.H., H.B.R., J.C.N.).
Heart Foundation · USConsultative and Diagnostic Center · RUOrthopedic Center · USResearch Center of Neurology · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCerebral injury is an important complication after cardiac surgery with the use of cardiopulmonary bypass. The rate of overt stroke after cardiac surgery is 1% to 2%, whereas silent strokes, detected by diffusion-weighted magnetic resonance imaging, are found in up to 50% of patients. It is unclear whether a higher versus a lower blood pressure during cardiopulmonary bypass reduces cerebral infarction in these patients.

methodsIn a patient- and assessor-blinded randomized trial, we allocated patients to a higher (70-80 mm Hg) or lower (40-50 mm Hg) target for mean arterial pressure by the titration of norepinephrine during cardiopulmonary bypass. Pump flow was fixed at 2.4 L·min

resultsAmong the 197 enrolled patients, mean (SD) age was 65.0 (10.7) years in the low-target group (n=99) and 69.4 (8.9) years in the high-target group (n=98). Procedural risk scores were comparable between groups. Overall, diffusion-weighted imaging revealed new cerebral lesions in 52.8% of patients in the low-target group versus 55.7% in the high-target group (

conclusionsAmong patients undergoing on-pump cardiac surgery, targeting a higher versus a lower mean arterial pressure during cardiopulmonary bypass did not seem to affect the volume or number of new cerebral infarcts. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT02185885.

Indexed as

AgedArterial PressureCardiac Surgical ProceduresCardiopulmonary BypassCerebral InfarctionDenmarkDiffusion Magnetic Resonance ImagingFemaleHumansIntraoperative CareMaleMiddle AgedNorepinephrineRisk FactorsTime FactorsTreatment OutcomeNorepinephrineVasoconstrictor Agentsblood pressurecardiopulmonary bypasscerebral infarctioncoronary artery bypassheart valvesneuroprotection

Identifiers

PMID29339351
OpenAlexW2783516228

What OpenQuestion holds

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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.