Evidence map›Paper›PMID 32557087›Full record

Trial reportJournal of anesthesia2020

Thromboelastometry and a hemostasis management system are most beneficial for guiding hemostatic therapy in cardiac surgery patients with a EuroSCORE II of ≥1.83%: a randomized controlled two-step trial.

Mitsuharu Kodaka, Junko Ichikawa, Kazuyoshi Ando, Makiko Komori

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of anesthesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Evaluation of the Safety and Efficacy of a Novel Thrombin Containing Combination Hemostatic Powder Using a Historical Control.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    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

4 authors at 1 institution in 1 country.

Mitsuharu KodakaDepartment of Anesthesiology and Intensive Care, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, 116-8567, Japan. kmkodaka@cb3.so-net.ne.jp.ORCID 0000-0002-0052-1020
Junko IchikawaDepartment of Anesthesiology and Intensive Care, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, 116-8567, Japan.
Kazuyoshi AndoDepartment of Anesthesiology and Intensive Care, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, 116-8567, Japan.
Makiko KomoriDepartment of Anesthesiology and Intensive Care, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, 116-8567, Japan.
Tokyo Women's Medical University Adachi Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe evaluated the efficacy of hemostatic therapy based on point-of-care (POC) testing in patients undergoing cardiac surgery.

methodsThis was a single-institution, prospective, randomized, double-blinded study. In step 1, 90 patients scheduled for elective cardiac surgery underwent complete blood count and fibrinogen measurements at baseline, after cardiopulmonary bypass (CPB) initiation (CPB start), just after CPB end, and in the intensive care unit (ICU). In step 2, 72 patients scheduled for elective cardiac surgery underwent conventional laboratory coagulation tests (control group) or POC coagulation tests (POC group). Transfusions were prepared using the fibrinogen and platelet values at mainly "CPB start" for the control group, and using the ROTEM values at mainly "CPB end" for the POC group. Consequently, the step 2 patients were divided into high- and low-risk subgroups based on the EuroSCORE II by logistic regression analysis; transfusion data and bleeding volumes were compared between the control and POC groups within the high- and low-risk subgroups.

resultsIn step 1, all blood components were significantly decreased at CPB start compared with baseline, and platelet and fibrinogen levels remained almost constant from CPB start to end. In step 2, the transfusion rates and perioperative bleeding volumes did not significantly differ between the control and POC groups. Subgroup analysis suggested that only the high-risk subgroup significantly differed regarding perioperative red blood cell transfusion and total bleeding volume in the ICU.

conclusionsPOC testing is beneficial for cardiac surgery patients with a EuroSCORE II of ≥1.83%.

Indexed as

Cardiac Surgical ProceduresHemostaticsCardiopulmonary BypassHemostasisHumansProspective StudiesThrombelastographyHemostaticsCardiovascular surgeryHepcon HMS plusThromboelastometry

Identifiers

PMID32557087
OpenAlexW3036682759

What OpenQuestion holds

Textmetadata
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.