Evidence map›Paper›PMID 30617461›Full record

Trial reportIntensive care medicine2019

The effect of local anesthetic continuous wound infusion for the prevention of postoperative pneumonia after on-pump cardiac surgery with sternotomy: the STERNOCAT randomized clinical trial.

Julien Amour, Bernard Cholley, Alexandre Ouattara, Dan Longrois, Pascal Leprince, Jean-Luc Fellahi, Bruno Riou, Sarah Hariri, Christian Latrémouille, Alain Rémy and 11 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01648777 (Cicatricial Analgesia Catheters Outcome on Bronchopulmonary Infection Number With Sternotomy Cardiac Operated), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.9field-weighted citation impact, top 10% 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.

NCT01648777 phase3completednot on this map

Cicatricial Analgesia Catheters Outcome on Bronchopulmonary Infection Number With Sternotomy Cardiac Operated

TypeinterventionalSponsorAssistance Publique - Hôpitaux de ParisRan2012 to 2015Enrolled1,502ConditionsPneumonia, Cardiac Surgery, Multiperforated Catheter, AnalgesiaArmsL bupivacaine, placebo
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 27 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Review
  6. 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

21 authors at 5 institutions in 1 country.

Julien AmourDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France. profjulien.amour@gmail.com.ORCID 0000-0003-0427-1337
Bernard CholleyDepartment of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, Université Paris-Descartes, Sorbonne Paris Cité, AP-HP, Paris, France.
Alexandre OuattaraBiology of Cardiovascular Diseases and Department of Anesthesiology and Critical Care, Magellan Medico-Surgical Center, University of Bordeaux, INSERM, UMR 1034, Bordeaux, France.
Dan LongroisDepartment of Anesthesiology and Critical Care Medicine, Hôpital Bichat-Claude Bernard, Unité INSERM U1148 (Laboratory for Vascular Translational Science), Université Paris-Diderot, Sorbonne Paris Cité, AP-HP, Paris, France.
Pascal LeprinceDepartment of Cardiovascular and Thoracic Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Jean-Luc FellahiUniversité Claude Bernard Lyon 1, Inserm U1060, Department of Anesthesiology and Critical Care Medicine, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France.
Bruno RiouDepartment of Emergency Medicine and Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Sarah HaririDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
Christian LatrémouilleDepartment of Cardiovascular and Thoracic Surgery, Hôpital Européen Georges Pompidou, Université Paris-Descartes, Sorbonne Paris Cité, AP-HP, Paris, France.
Alain RémyBiology of Cardiovascular Diseases and Department of Anesthesiology and Critical Care, Magellan Medico-Surgical Center, University of Bordeaux, INSERM, UMR 1034, Bordeaux, France.
Sophie ProvenchèreDepartment of Anesthesiology and Critical Care Medicine, Hôpital Bichat-Claude Bernard, Unité INSERM U1148 (Laboratory for Vascular Translational Science), Université Paris-Diderot, Sorbonne Paris Cité, AP-HP, Paris, France.
Aude CarillionDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
Paul AchouhDepartment of Cardiovascular and Thoracic Surgery, Hôpital Européen Georges Pompidou, Université Paris-Descartes, Sorbonne Paris Cité, AP-HP, Paris, France.
Louis LabrousseDepartment of Cardiovascular and Thoracic Surgery, Magellan Medico-Surgical Center, University of Bordeaux, INSERM, UMR 1034, Bordeaux, France.
Alexy Tran DinhDepartment of Anesthesiology and Critical Care Medicine, Hôpital Bichat-Claude Bernard, Unité INSERM U1148 (Laboratory for Vascular Translational Science), Université Paris-Diderot, Sorbonne Paris Cité, AP-HP, Paris, France.
Nora Ait HamouDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
Ahmed CharfeddineDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
Alexandre LafourcadeDepartment of Biostatistic, Public Health and Medical Information, Pitié-Salpêtrière Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
David HajageDepartment of Biostatistic, Public Health and Medical Information, Pitié-Salpêtrière Hospital, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Adrien BougléDepartment of Anesthesiology and Critical Care Medicine, Pitié-Salpêtrière Hospital, Institut de Cardiologie, Réanimation de Chirurgie Cardiaque, Sorbonne Université, UMR INSERM 1166, IHU ICAN, Assistance Publique-Hôpitaux de Paris (AP-HP), 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
STERNOCAT investigators
Inserm · FRUniversité de Bordeaux · FRUniversité Claude Bernard Lyon 1 · FRDélégation Paris 5 · FRSorbonne Université · FR

Funding

PHRC P100107
6 · The paper itself

Abstract

purposePostoperative pain after cardiac surgery, exacerbated by cough and sternal mobilization, limits clearance of bronchopulmonary secretions and may predispose to postoperative pneumonia. In this study, we tested the ability of local anesthetic continuous wound infusion to prevent pneumonia after cardiac surgery with sternotomy and cardiopulmonary bypass (CPB) owing to better analgesia and bronchopulmonary drainage.

methodsIn this randomized, double-blind, placebo-controlled trial conducted in five academic centers, patients undergoing cardiac surgery with sternotomy and CPB were enrolled from February 2012 until November 2014, and were followed over 30 days. Patients were assigned to a 48-h infusion (10 ml h

resultsAmong 1493 randomized patients, 1439 completed the trial. Pneumonia occurred in 36/746 patients (4.9%) in the L-bupivacaine group and in 42/739 patients (5.7%) in the placebo group (absolute risk difference taking into account center and baseline risk of postoperative pneumonia, - 1.3% [95% CI - 3.4; 0.8] P = 0.22). In the predefined subgroup of patients at high risk, L-bupivacaine decreased the incidence of pneumonia (absolute risk difference, - 5.6% [95% CI - 10.0; - 1.1], P = 0.01).

conclusionsAfter cardiac surgery with sternotomy, continuous wound infusion of L-bupivacaine failed to decrease the incidence of pneumonia. These findings do not support the use of local anesthetic continuous wound infusion in this indication. Further study should investigate its effect in high-risk patients.

trial registrationEudraCT Number: 2011-003292-10; Clinicaltrials.gov Identifier: NCT01648777.

Indexed as

Academic Medical CentersAgedAged, 80 and overAnesthetics, LocalBupivacaineCardiac Surgical ProceduresDouble-Blind MethodFemaleFranceHumansInfusion PumpsMaleMiddle AgedPlacebosPneumoniaPostoperative ComplicationsAnesthetics, LocalBupivacainePlacebosCardiac surgeryCritical care medicineLocal anestheticsPneumoniaPostoperative pain

Identifiers

PMID30617461
OpenAlexW2908647626

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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.