Evidence map›Paper›PMID 30424770›Full record

ArticleTrials2018

A perioperative surgeon-controlled open-lung approach versus conventional protective ventilation with low positive end-expiratory pressure in cardiac surgery with cardiopulmonary bypass (PROVECS): study protocol for a randomized controlled trial.

David Lagier, François Fischer, William Fornier, Jean-Luc Fellahi, Pascal Colson, Bernard Cholley, Samir Jaber, Karine Baumstarck, Catherine Guidon, PROVECS investigators and the ARCOTHOVA group

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06967142 (Fluid Responsiveness Through the Corrected Carotid Flow Time, Before and After Sternotomy), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.5field-weighted citation impact, top 29% 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.

NCT06967142 completednot on this mapstarted 2025, after this paper: background citation

Fluid Responsiveness Through the Corrected Carotid Flow Time, Before and After Sternotomy

TypeobservationalSponsorAnkara City Hospital BilkentRan2025 to 2025Enrolled45ConditionsCoronary Artery DiseaseArmsCorrecte Carotid flow measurement by USG Doppler
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 14 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 5 institutions in 1 country.

David LagierDepartment of Cardiovascular Anesthesiology and Critical Care Medicine, La Timone University Hospital, AP-HM and Aix-Marseille University, 264 rue saint Pierre, 13005, cedex 5, Marseille, France. david.lagier@ap-hm.fr.ORCID http://orcid.org/0000-0003-3861-5062
François FischerDepartment of Cardiovascular and Thoracic Anesthesiology, Nouvel Hôpital Civil, Strasbourg, France.
William FornierDepartment of Anesthesiology and Critical Care Medicine, Louis Pradel University Hospital and University Claude Bernard, 28 Avenue du Doyen Lépine, 69677, Bron, France.
Jean-Luc FellahiDepartment of Anesthesiology and Critical Care Medicine, Louis Pradel University Hospital and University Claude Bernard, 28 Avenue du Doyen Lépine, 69677, Bron, France.
Pascal ColsonDepartment of Anesthesiology and Critical Care Medicine, Arnaud de Villeneuve University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France.
Bernard CholleyDepartment of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, AP-HP and University Paris Descartes-Sorbonne Paris Cité, 20 Rue Leblanc, 75015, Paris, France.
Samir JaberDepartment of Anesthesiology and Critical Care Medicine, Saint Eloi University Hospital, 80 Avenue Augustin Fliche, 34295, Montpellier, France.
Karine BaumstarckUnité de Recherche EA3279, Aix-Marseille University, 27 bd Jean Moulin, Marseille, cedex 5, 13385, Marseille, France.
Catherine GuidonDepartment of Cardiovascular Anesthesiology and Critical Care Medicine, La Timone University Hospital, AP-HM and Aix-Marseille University, 264 rue saint Pierre, 13005, cedex 5, Marseille, France.
PROVECS investigators and the ARCOTHOVA group
Aix-Marseille Université · FRUniversité Claude Bernard Lyon 1 · FRDélégation Paris 5 · FRHôpital de la Timone · FRInserm · FR

Funding

Direction Générale de l'offre de Soins PHRC-I 2015
6 · The paper itself

Abstract

backgroundPostoperative pulmonary complications (PPCs) are frequent after on-pump cardiac surgery. Cardiac surgery results in a complex pulmonary insult leading to high susceptibility to perioperative pulmonary atelectasis. For technical reasons, ventilator settings interact with the surgical procedure and traditionally, low levels of positive end-expiratory pressure (PEEP) have been used. The objective is to compare a perioperative, multimodal and surgeon-controlled open-lung approach with conventional protective ventilation with low PEEP to prevent PPCs in patients undergoing cardiac surgery. METHODS/

designThe perioperative open-lung protective ventilation in cardiac surgery (PROVECS) trial is a multicenter, two-arm, randomized controlled trial. In total, 494 patients scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB) and aortic cross-clamp will be randomized into one of the two treatment arms. In the experimental group, systematic recruitment maneuvers and perioperative high PEEP (8 cmH2O) are associated with ultra-protective ventilation during CPB. In this group, the settings of the ventilator are controlled by surgeons in relation to standardized protocol deviations. In the control group, no recruitment maneuvers, low levels of PEEP (2 cmH2O) and continuous positive airway pressure during CPB (2 cmH2O) are used. Low tidal volumes (6-8 mL/kg of predicted body weight) are used before and after CPB in each group. The primary endpoint is a composite of the single PPCs evaluated during the first 7 postoperative days. DISCUSSION: The PROVECS trial will be the first multicenter randomized controlled trial to evaluate the impact of a perioperative and multimodal open-lung ventilatory strategy on the occurrence of PPCs after on-pump cardiac surgery. The trial design includes standardized surgeon-controlled protocol deviations that guarantee a pragmatic approach. The results will help anesthesiologists and surgeons aiming to optimize ventilatory settings during cardiac surgery.

trial registrationClinical Trials.gov, NCT 02866578 . Registered on 15 August 2016. Last updated 11 July 2017.

Indexed as

Cardiac Surgical ProceduresCardiopulmonary BypassPerioperative CareRandomized Controlled Trials as TopicSurgeonsAdultHumansLung DiseasesMulticenter Studies as TopicPositive-Pressure RespirationPostoperative ComplicationsPragmatic Clinical Trials as TopicProspective StudiesResearch DesignCardiac surgeryCardiopulmonary bypassMechanical ventilationPositive end-expiratory pressurePostoperative pulmonary complications

Identifiers

PMID30424770
PMCPMC6234562
OpenAlexW2900872283

What OpenQuestion holds

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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.