Evidence map›Paper›PMID 31771666›Full record

ArticleCardiology in the young2020

Association between preoperative respiratory support and outcomes in paediatric cardiac surgery.

Elizabeth C Ciociola, Karan R Kumar, Kanecia O Zimmerman, Elizabeth J Thompson, Melissa Harward, Laura N Sullivan, Joseph W Turek, Christoph P Hornik

Abstract read
In one paragraph

Article in Cardiology in the young, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. The ductus arteriosus in neonates with critical congenital heart disease.Journal of perinatology : official journal of the California Perinatal Association · 2022
    Review
  4. The role of furosemide and fluid management for a hemodynamically significant patent ductus arteriosus in premature infants.Journal of perinatology : official journal of the California Perinatal Association · 2022
    Review
  5. 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

8 authors.

Elizabeth C CiociolaDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Karan R KumarDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Kanecia O ZimmermanDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Elizabeth J ThompsonDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Melissa HarwardDepartment of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Laura N SullivanDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Joseph W TurekDepartment of Surgery, Duke University Medical Center, Durham, NC, USA.
Christoph P HornikDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.ORCID https://orcid.org/0000-0001-7056-8759

Funding

Pharmacokinetics, Pharmacodynamics, and Safety of Methylprednisolone in Neonates on Cardiopulmonary BypassK23HD090239 · NICHD · DUKE UNIVERSITY · PI HORNIK, CHRISTOPH · 2017 to 2020
$646k
Investigating polypharmacy-related adverse events in critically ill children using electronic health records and simulated drug levelsK23HD091398 · NICHD · DUKE UNIVERSITY · PI ZIMMERMAN, KANECIA OBIE · 2017 to 2020
$629k
Bridging the Gap to Enhance Clinical Research Program (BIGGER)R25HL135304 · NHLBI · DUKE UNIVERSITY · PI CHU, VIVIAN H, THOMAS, KEVIN L · 2017 to 2021
$487k
NHLBI NIH HHS R25 HL135304NICHD NIH HHS HHSN267200700051CNICHD NIH HHS K23 HD090239NICHD NIH HHS K23 HD091398
6 · The paper itself

Abstract

backgroundPreoperative mechanical ventilation is associated with morbidity and mortality following CHD surgery, but prior studies lack a comprehensive analysis of how preoperative respiratory support mode and timing affects outcomes.

methodsWe retrospectively collected data on children <18 years of age undergoing cardiac surgery at an academic tertiary care medical centre. Using multivariable regression, we examined the association between modes of preoperative respiratory support (nasal cannula, high-flow nasal cannula/noninvasive ventilation, or invasive mechanical ventilation), escalation of preoperative respiratory support, and invasive mechanical ventilation on the day of surgery for three outcomes: operative mortality, postoperative length of stay, and postoperative complications. We repeated our analysis in a subcohort of neonates.

resultsA total of 701 children underwent 800 surgical procedures, and 40% received preoperative respiratory support. Among neonates, 243 patients underwent 253 surgical procedures, and 79% received preoperative respiratory support. In multivariable analysis, all modes of preoperative respiratory support, escalation in preoperative respiratory support, and invasive mechanical ventilation on the day of surgery were associated with increased odds of prolonged length of stay in children and neonates. Children (odds ratio = 3.69, 95% CI 1.2-11.4) and neonates (odds ratio = 8.97, 95% CI 1.31-61.14) on high-flow nasal cannula/noninvasive ventilation had increased odds of operative mortality compared to those on room air.

conclusionPreoperative respiratory support is associated with prolonged length of stay and mortality following CHD surgery. Knowing how preoperative respiratory support affects outcomes may help guide surgical timing, inform prognostic conversations, and improve risk stratification models.

Indexed as

AdolescentCardiac Surgical ProceduresChildChild, PreschoolFemaleHeart Defects, CongenitalHumansInfantInfant, NewbornIntensive Care Units, PediatricLength of StayLogistic ModelsMaleMultivariate AnalysisNoninvasive VentilationNorth CarolinaCHDnoninvasive ventilationpaediatric cardiac surgerypostoperative length of staypreoperative ventilationrespiratory support

Identifiers

PMID31771666
PMCPMC7018562

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Registered trials

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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.