Evidence map›Paper›PMID 30563555›Full record

ArticleTrials2018

Prevention of post-operative complications by using a HMG-CoA reductase inhibitor in patients undergoing one-lung ventilation for non-cardiac surgery: study protocol for a randomised controlled trial.

Murali Shyamsundar, Cecilia O'Kane, Gavin D Perkins, Gavin Kennedy, Christina Campbell, Ashley Agus, Glenn Phair, Danny McAuley

Open access · goldAbstract readClinical Trial Protocol
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. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 34% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Trial
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

8 authors at 3 institutions in 1 country.

Murali ShyamsundarCentre for Experimental Medicine, Queen's University Belfast, Belfast, BT9 7BL, UK. murali.shyamsundar@qub.ac.uk.ORCID http://orcid.org/0000-0003-3797-8080
Cecilia O'KaneCentre for Experimental Medicine, Queen's University Belfast, Belfast, BT9 7BL, UK.
Gavin D PerkinsWarwick Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.
Gavin KennedyNorthern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Hospitals, Belfast, BT12 6BA, UK.
Christina CampbellNorthern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Hospitals, Belfast, BT12 6BA, UK.
Ashley AgusNorthern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Hospitals, Belfast, BT12 6BA, UK.
Glenn PhairNorthern Ireland Clinical Trials Unit, 1st Floor Elliott Dynes Building, Royal Hospitals, Belfast, BT12 6BA, UK.
Danny McAuleyCentre for Experimental Medicine, Queen's University Belfast, Belfast, BT9 7BL, UK.
University of Ulster · GBQueen's University Belfast · GBUniversity of Warwick · GB

Funding

Medical Research Council MC_G1002460Public Health Agency CDV/5137/15
6 · The paper itself

Abstract

backgroundPostoperative pulmonary complications (PPC) and peri-operative myocardial infarction (MI) have a significant impact on the long-term mortality of surgical patients. Patients undergoing one-lung ventilation (OLV) for surgery are at a high risk of developing these complications. These complications could be associated with intensive care unit (ICU) admissions and longer hospital stay with associated resource and economic burden. Simvastatin, a HMG-CoA reductase enzyme inhibitor has been shown to have pleiotropic anti-inflammatory effects as well as being endothelial protective. The benefits of statins have been shown in various observational studies and in small proof-of-concept studies. There is an urgent need for a well-designed, large clinical trial powered to detect clinical outcomes. The Prevention HARP 2 trial will test the hypothesis 'simvastatin 80 mg when compared to placebo will reduce cardiac and pulmonary complications in patients undergoing elective oesophagectomy, lobectomy or pneumonectomy'. METHODS/

designThe Prevention HARP 2 trial is a UK multi-centre, randomised, double-blind, placebo-controlled trial. Adult patients undergoing elective oesophagectomy, lobectomy or pneumonectomy will be eligible. Patients who are already on statins will be excluded from this trial. Patients will be randomised to receive simvastatin 80 mg or matched placebo for 4 days pre surgery and for up to 7 days post surgery. The primary outcome is a composite outcome of PPC and MI within 7 days post surgery. Various secondary outcome measures including clinical outcomes, safety outcomes and health economic outcomes will be collected. The study aims to recruit 452 patients in total across 12 UK sites. DISCUSSION: The results of the Prevention HARP 2 trial should add to our understanding of the benefits of peri-operative statins and influence clinical decision-making. Analysis of blood and urine samples from the patients will provide insight into the mechanism of simvastatin action.

trial registrationInternational Standard Randomised Controlled Trials registry, ID: ISRCTN48095567 . Registered on 11 November 2016.

Indexed as

EsophagectomyOne-Lung VentilationPneumonectomyDouble-Blind MethodElective Surgical ProceduresHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMulticenter Studies as TopicMyocardial InfarctionRandomized Controlled Trials as TopicRespiratory Distress SyndromeRisk FactorsSimvastatinTime FactorsTreatment OutcomeUnited KingdomHydroxymethylglutaryl-CoA Reductase InhibitorsSimvastatinAcute respiratory distress syndromeLobectomyOesophagectomyOne-lung ventilationPneumonectomyPost-operative myocardial infarctionPost-operative pulmonary complicationSimvastatin

Identifiers

PMID30563555
PMCPMC6299644
OpenAlexW2905563243

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.