Evidence map›Paper›PMID 32782813›Full record

ArticleCanadian journal of kidney health and disease2020

Starch or Saline After Cardiac Surgery: A Double-Blinded Randomized Controlled Trial.

A Dave Nagpal, Andrea Cowan, Linna Li, Graeme Nusca, Linrui Guo, Richard J Novick, Chris C Harle, Andrew A House, Stephanie Fox, Philip M Jones

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

Article in Canadian journal of kidney health and disease, 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
0.3field-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, 3 citations in OpenAlex.

  1. Article
  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

10 authors at 1 institution in 1 country.

A Dave NagpalDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Andrea CowanDepartment of Medicine, Division of Nephrology, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-9480-969X
Linna LiDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Graeme NuscaDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Linrui GuoDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Richard J NovickDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Chris C HarleDepartment of Anesthesia & Perioperative Medicine, Western University, London, ON, Canada.
Andrew A HouseDepartment of Medicine, Division of Nephrology, Western University, London, ON, Canada.
Stephanie FoxDepartment of Surgery, Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
Philip M JonesDepartment of Anesthesia & Perioperative Medicine, Western University, London, ON, Canada.
Western University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite decades of investigation, the balance of clinical risks and benefits of fluid supplementation with starch remain unresolved. Patient-centered outcomes have not been well explored in a "real-world" trial in cardiac surgery.

objectiveWe sought to compare a starch-based fluid strategy with a saline-based fluid strategy in the cardiac surgery patient.

designA pragmatic blinded randomized controlled trial comparing starch-based with saline-based fluid strategy.

settingA large tertiary academic center in London Ontario between September 2009 and February 2011.

participantsPatients undergoing planned, isolated coronary revascularization. MEASUREMENTS: Serum creatinine and patient weight were measured daily postoperatively.

methodsPatients were randomized to receive 6% hydroxyethyl starch (Voluven) or saline for perioperative fluid requirements. Fluid administration was not protocolized. Co-primary outcomes were incidence of acute kidney injury (AKI) and maximum postoperative weight gain. Secondary outcomes included bleeding, transfusion, inotropic and ventilator support, and fluid utilization.

resultsThe study was prematurely terminated due to resource limitations. A total of 69 patients (19% female, mean age = 65) were randomized. Using RIFLE criteria for AKI, "risk" occurred in 12 patients in each group (risk ratio [RR] = 1.0; 95% confidence interval [CI] = 0.5-1.9; LIMITATIONS: The study had to be prematurely terminated due to resource limitations which led to a small sample size which was not sufficiently powered to detect a difference in the primary outcomes.

conclusionsThis pragmatic double-blinded randomized controlled trial revealed a number of interesting hypothesis-generating trends and confirmed the feasibility of undertaking a logistically complex trial in a pragmatic fashion.

Indexed as

cardiac surgical procedurescritical carefluid therapypostoperative care

Identifiers

PMID32782813
PMCPMC7388134
OpenAlexW3046077744

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.