Evidence map›Paper›PMID 32648069›Full record

ArticleAnnals of intensive care2020

Impact of the perioperative inotropic support in grown-up congenital heart patients undergoing cardiac surgery: a propensity score adjusted analysis.

Philippe Mauriat, Mirela Bojan, Sylvie Soulie, Hélène Foulgoc, Nadir Tafer, Alexandre Ouattara

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 35% 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, 4 citations in OpenAlex.

  1. Review
  2. 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

6 authors at 3 institutions in 1 country.

Philippe MauriatDepartment of Anaesthesia and Critical Care, University of Bordeaux, Haut-Levêque Hospital, Avenue Magellan, 33000, Pessac, France. philippe.mauriat@me.com.ORCID http://orcid.org/0000-0002-1711-3322
Mirela BojanDepartment of Anaesthesia, Congenital Cardiac Unit, Marie-Lannelongue Hospital, Paris-Sud University, 133 Avenue de la Résistance, 92350, Le Plessis-Robinson, France.
Sylvie SoulieDepartment of Anesthesia and Critical Care, Louis Pradel Hospital, University of Lyon, 59 Boulevard Pinel, 69500, Bron, France.
Hélène FoulgocDepartment of Anaesthesia and Critical Care, University of Bordeaux, Haut-Levêque Hospital, Avenue Magellan, 33000, Pessac, France.
Nadir TaferDepartment of Anaesthesia and Critical Care, University of Bordeaux, Haut-Levêque Hospital, Avenue Magellan, 33000, Pessac, France.
Alexandre OuattaraDepartment of Anaesthesia and Critical Care, University of Bordeaux, Haut-Levêque Hospital, Avenue Magellan, 33000, Pessac, France.
Université de Bordeaux · FRUniversité Claude Bernard Lyon 1 · FRUniversité Paris-Sud · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGrown-up congenital heart (GUCH) patients represent a growing population with a high morbidity risk when undergoing reparative surgery. A main preoperative feature is right ventricular failure, which represents a risk factor for postoperative low cardiac output syndrome. Levosimendan has a potentially beneficial effect. This retrospective study included consecutive GUCH patients with surgeries in a tertiary cardiothoracic centre between 01-01-2013 and 01-10-2017, to test the hypothesis that the postoperative use of levosimendan might be associated with shorter time of mechanical ventilation, when compared with the use of milrinone. To adjust for bias related to the probability of treatment assignment, it uses the inverse propensity score weighting methodology.

resultsOverall 363 patients had GUCH surgeries during the study period, their mean age was 31.39 ± 15.31 years, 87 patients were eligible for analysis in the Levosimendan group and 117 in the Milrinone group. The propensity score used pre- and intraoperative variables and resulted in a good balance between covariates. The Levosimendan group included patients with higher preoperative risk scores, a higher prevalence of left and right ventricular failure, who required more often the addition of epinephrine, renal replacement therapy, prolonged mechanical ventilation and intensive care stay. However, after propensity score weighting, patients in the Levosimendan group had shorter durations of mechanical ventilation (average treatment effect - 37.59 h IQR [- 138.85 to - 19.13], p = 0.01) and intensive care stay (average treatment effect - 3.11 days IQR [- 10.03 to - 1.48], p = 0.009). The number of days of additional epinephrine support was shorter and the vasoactive inotropic scores lower.

conclusionWe report a beneficial effect in terms of duration of mechanical ventilation and intensive care stay, and on inotropic requirements of the use of levosimendan following GUCH surgeries. The use of levosimendan in this setting requires validation at a larger scale.

Indexed as

Adult congenital cardiac surgeryGrown-up congenital heartInotropic-vasoactive supportIntensive care stayLevosimendanMechanical ventilationMilrinonePostoperative low cardiac output syndrome

Identifiers

PMID32648069
PMCPMC7344035
OpenAlexW3041790961

What OpenQuestion holds

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LicenceCC BY
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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.