Evidence map›Paper›PMID 31773324›Full record

ArticleAnnals of intensive care2019

Intra-aortic balloon pump does not influence cerebral hemodynamics and neurological outcomes in high-risk cardiac patients undergoing cardiac surgery: an analysis of the IABCS trial.

Juliana R Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Graziela S R Ferreira, Ligia Camara, Rogério H Passos, Angela M Salinet, Daniel S Azevedo, Marcelo de-Lima-Oliveira, Filomena R B G Galas and 7 more

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

Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02143544 (Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% 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.

NCT02143544 naunknown statusnot on this map

Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery: a Randomized Controlled Trial

TypeinterventionalSponsorUniversity of Sao PauloRan2014 to 2016Enrolled180ConditionsPostoperative, Dysfunction Following Cardiac SurgeryArmsIntra-aortic balloon pump.
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. POCUS, how can we include the brain? An overview.Journal of anesthesia, analgesia and critical care · 2022
    Review
  4. Article
  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

17 authors at 6 institutions in 4 countries.

Juliana R CaldasDepartment of Anesthesia, University of São Paulo, São Paulo, São Paulo, Brazil.
Ronney B PaneraiDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Edson Bor-Seng-ShuDepartment of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Graziela S R FerreiraDepartment of Cardiopneumology, Universidade de São Paulo, São Paulo, Brazil.
Ligia CamaraDepartment of Anesthesia, University of São Paulo, São Paulo, São Paulo, Brazil.
Rogério H PassosCritical Care Unit Hospital São Rafael Salvador, Salvador, Brazil.
Angela M SalinetDepartment of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Daniel S AzevedoDepartment of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Marcelo de-Lima-OliveiraDepartment of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Filomena R B G GalasDepartment of Anesthesia, University of São Paulo, São Paulo, São Paulo, Brazil.
Julia T FukushimaDepartment of Anesthesia, University of São Paulo, São Paulo, São Paulo, Brazil.
Ricardo NogueiraDepartment of Neurosurgery, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
Fabio S TacconeDepartment of Intensive Care, Hopital Erasme, Brussels, Belgium.
Giovanni LandoniDepartment of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University of Milan, Milan, Italy.
Juliano P AlmeidaDepartment of Anesthesia, University of São Paulo, São Paulo, São Paulo, Brazil.
Thompson G RobinsonDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Ludhmila A HajjarDepartment of Cardiopneumology, Universidade de São Paulo, São Paulo, Brazil. ludhmila@usp.br.
Universidade de São Paulo · BRHospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo · BRNIHR Leicester Biomedical Research Centre · GBErasmus Hospital · BEHospital São Rafael · BRVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe intra-aortic balloon pump (IABP) is often used in high-risk patients undergoing cardiac surgery to improve coronary perfusion and decrease afterload. The effects of the IABP on cerebral hemodynamics are unknown. We therefore assessed the effect of the IABP on cerebral hemodynamics and on neurological complications in patients undergoing cardiac surgery who were randomized to receive or not receive preoperative IABP in the 'Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery' (IABCS) trial.

methodsThis is a prospectively planned analysis of the previously published IABCS trial. Patients undergoing elective coronary artery bypass surgery with ventricular ejection fraction ≤ 40% or EuroSCORE ≥ 6 received preoperative IABP (n = 90) or no IABP (n = 91). Cerebral blood flow velocity (CBFV) of the middle cerebral artery through transcranial Doppler and blood pressure through Finometer or intra-arterial line were recorded preoperatively (T1) and 24 h (T2) and 7 days after surgery (T3) in patients with preoperative IABP (n = 34) and without IABP (n = 33). Cerebral autoregulation was assessed by the autoregulation index that was estimated from the CBFV response to a step change in blood pressure derived by transfer function analysis. Delirium, stroke and cognitive decline 6 months after surgery were recorded.

resultsThere were no differences between the IABP and control patients in the autoregulation index (T1: 5.5 ± 1.9 vs. 5.7 ± 1.7; T2: 4.0 ± 1.9 vs. 4.1 ± 1.6; T3: 5.7 ± 2.0 vs. 5.7 ± 1.6, p = 0.97) or CBFV (T1: 57.3 ± 19.4 vs. 59.3 ± 11.8; T2: 74.0 ± 21.6 vs. 74.7 ± 17.5; T3: 71.1 ± 21.3 vs. 68.1 ± 15.1 cm/s; p = 0.952) at all time points. Groups were not different regarding postoperative rates of delirium (26.5% vs. 24.2%, p = 0.83), stroke (3.0% vs. 2.9%, p = 1.00) or cognitive decline through analysis of the Mini-Mental State Examination (16.7% vs. 40.7%; p = 0.07) and Montreal Cognitive Assessment (79.16% vs. 81.5%; p = 1.00).

conclusionsThe preoperative use of the IABP in high-risk patients undergoing cardiac surgery did not affect cerebral hemodynamics and was not associated with a higher incidence of neurological complications. Trial registration http://www.clinicaltrials.gov (NCT02143544).

Indexed as

Cardiopulmonary bypassCerebral autoregulationIABPTranscranial Doppler

Identifiers

PMID31773324
PMCPMC6879692
OpenAlexW2991325654

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.