Evidence map›Paper›PMID 30511259›Full record

SynthesisJournal of thrombosis and thrombolysis2019

Restrictive versus liberal red blood cell transfusion for cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.

Babikir Kheiri, Ahmed Abdalla, Mohammed Osman, Tarek Haykal, Sai Chintalapati, James Cranford, Jason Sotzen, Meghan Gwinn, Sahar Ahmed, Mustafa Hassan and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of thrombosis and thrombolysis, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

11 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Patient blood management in the ICU: A narrative review of the literature.European journal of anaesthesiology and intensive care · 2022
    Review
  8. Article
  9. Article
  10. Article
  11. Article
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

12 authors.

Babikir KheiriDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Ahmed AbdallaDivision of Hematology & Oncology, Ascension St. John Hospital, Grosse Pointe Woods, MI, 48236, USA.
Mohammed OsmanDivision of Cardiology, West Virginia University School of Medicine, Morgantown, WV, 26506, USA.
Tarek HaykalDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Sai ChintalapatiDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
James CranfordDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Jason SotzenDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Meghan GwinnMichigan State University-College of Human Medicine, Flint, MI, 48502, USA.
Sahar AhmedDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Mustafa HassanDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Ghassan BachuwaDepartment of Internal Medicine, Hurley Medical Center/Michigan State University, Flint, MI, 48503, USA.
Deepak L BhattBrigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. dlbhattmd@post.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients undergoing cardiac surgery are among the most common recipients of allogeneic red blood cell (RBC) transfusions. However, whether restrictive RBC transfusion strategies for cardiac surgery achieve a similar clinical outcome in comparison with liberal strategies remains unclear. We searched electronic databases from inception to December 2017 for randomized controlled trials (RCTs). We calculated the risk ratios (RRs) and weighted-mean difference (MD) using a random-effects model. We included 9 RCTs with a total of 9005 patients. There was no significant difference in mortality between groups [RR 1.03; 95% confidence interval (CI) 0.74-1.45; P = 0.86]. In addition, there were no significant differences between groups in the clinical outcomes of infections (RR 1.09; 95% CI 0.94-1.26; P = 0.26), stroke (RR 0.98; 95% CI 0.72-1.35; P = 0.91), respiratory morbidity (RR 1.05; 95% CI 0.89-1.24; P = 0.58), renal morbidity (RR 1.02; 95% CI 0.94-1.09; P = 0.68), myocardial infarction (RR 1.00; 95% CI 0.80-1.24; P = 0.99), cardiac arrhythmia (RR 1.05; 95% CI 0.88-1.26; P = 0.56), gastrointestinal morbidity (RR 1.93; 95% CI 0.81-4.63; P = 0.14), or reoperation (RR 0.90; 95% CI 0.67-1.20; P = 0.46). There was a significant difference in the intensive care unit length of stay (h) (MD 4.29; 95% CI 2.19-6.39, P < 0.01) favoring the liberal group. However, there was no significant difference in the hospital length of stay (days) (MD 0.15; 95% CI - 0.18 to 0.48; P = 0.38). In conclusion, this meta-analysis showed that restrictive strategies for RBC transfusion are as safe as liberal strategies in patients undergoing cardiac surgery with regards to short-term clinical outcomes.

Indexed as

Cardiac Surgical ProceduresBlood Loss, SurgicalErythrocyte TransfusionHumansLength of StayRandomized Controlled Trials as TopicRisk FactorsTime FactorsTreatment OutcomeCardiac surgeryMeta-analysisRed blood cell transfusionRestrictive

Identifiers

PMID30511259

What OpenQuestion holds

Textmetadata
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.