Evidence map›Paper›PMID 31843691›Full record

ArticleJournal of the American College of Surgeons2020

Examining the Effect of Hypertonic Saline Administered for Reduction of Intracranial Hypertension on Coagulation.

Julia R Coleman, Ernest E Moore, Christopher C Silliman, Gregory R Stettler, Geoffrey R Nunns, Jason M Samuels, Matthew G Bartley, Navin G Vigneshwar, Mitchell J Cohen, Miguel Fragoso and 1 more

Open access · greenAbstract read
In one paragraph

Article in Journal of the American College of Surgeons, 2020. 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
0.2field-weighted citation impact, top 43% 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, 5 citations in OpenAlex.

  1. 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

11 authors at 2 institutions in 1 country.

Julia R ColemanDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Ernest E MooreDepartment of Surgery, University of Colorado-Denver, Aurora, CO; Department of Surgery, Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO. Electronic address: Ernest.moore@dhha.org.
Christopher C SillimanDepartment of Hematology, Children's Hospital of Colorado, Aurora, CO; Vitalant Research Institute, Vitalant Denver, Denver, CO.
Gregory R StettlerDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Geoffrey R NunnsDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Jason M SamuelsDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Matthew G BartleyDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Navin G VigneshwarDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Mitchell J CohenDepartment of Surgery, University of Colorado-Denver, Aurora, CO; Department of Surgery, Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO.
Miguel FragosoDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
Angela SauaiaDepartment of Surgery, University of Colorado-Denver, Aurora, CO.
University of Colorado Denver · USDenver Health Medical Center · US

Funding

Analysis and Characterization of Trauma-Induced CoagulopathyUM1HL120877 · NHLBI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI MORRISSEY, JAMES H., WISNIEWSKI, STEPHEN R · 2013 to 2019
$26.6M
Trauma Reprograms CellsP50GM049222 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI BANERJEE, ANIRBAN · 1993 to 2017
$26.1M
Resuscitation Strategies for Achieving Thrombo-inflammatory HomeostasisRM1GM131968 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI COHEN, MITCHELL, D'ALESSANDRO, ANGELO · 2019 to 2023
$11.3M
Mechanisms of Trauma-Induced CoagulopathyT32GM008315 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI Mitchell Cohen, ELIZABETH J. KOVACS · 1991 to 2026
$7.1M
The role of ferroptosis in red cell aging in vivo and in vitroR01HL146442 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI Angelo D'Alessandro, Adam N. Goldfarb · 2019 to 2026
$5.4M
NHLBI NIH HHS R01 HL146442NHLBI NIH HHS UM1 HL120877NIGMS NIH HHS P50 GM049222NIGMS NIH HHS RM1 GM131968NIGMS NIH HHS T32 GM008315
6 · The paper itself

Abstract

backgroundHypertonic saline (23.4%, HTS) bolus administration is common practice for refractory intracranial hypertension, but its effects on coagulation are unknown. We hypothesize that 23.4% HTS in whole blood results in progressive impairment of coagulation in vitro and in vivo in a murine model of traumatic brain injury (TBI). STUDY

designFor the in vitro study, whole blood was collected from 10 healthy volunteers, and citrated native thrombelastography was performed with normal saline (0.9%, NS) and 23.4% HTS in serial dilutions (2.5%, 5%, and 10%). For the in vivo experiment, we assessed the effects of 23.4% HTS bolus vs NS on serial thrombelastography and tail-bleeding times in a TBI murine model (n = 10 rats with TBI and 10 controls).

resultsFor the in vitro work, clinically relevant concentrations of HTS (2.5% dilution) shortened time to clot formation and increased clot strength (maximum amplitude) compared with control and NS. With higher HTS dosing (5% and 10% blood dilution), there was progressive prolongation of time to clot formation, decreased angle, and decreased maximum amplitude. In the in vivo study, there was no significant difference in thrombelastography measurements or tail-bleeding times after bolus administration of 23.4% HTS compared with NS at 2.5% blood volume.

conclusionsAt clinically relevant dilutions of HTS, there is a paradoxical shortening of time to clot formation and increase in clot strength in vitro and no significant effects in a murine TBI model. However, with excess dilution, caution should be exercised when using serial HTS boluses in TBI patients at risk for trauma-induced coagulopathy.

Indexed as

AnimalsBlood CoagulationBrain Injuries, TraumaticDisease Models, AnimalFemaleHumansIntracranial HypertensionMaleRats, Sprague-DawleySaline Solution, HypertonicSelf ReportThrombelastographyTime FactorsSaline Solution, Hypertonic

Identifiers

PMID31843691
PMCPMC7050279
OpenAlexW2995575583

What OpenQuestion holds

Textmetadata
LicenceTDM
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.