Evidence map›Paper›PMID 34061871›Full record

ArticlePloS one2021

Autonomic biomarkers of shock in idiopathic systemic capillary leak syndrome.

Maddalena Alessandra Wu, Emanuele Catena, Antonio Castelli, Roberto Rech, Beatrice Borghi, Davide Ottolina, Tommaso Fossali, Chiara Cogliati, Riccardo Colombo

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. 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 40% 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, 2 citations in OpenAlex.

  1. Article
  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

9 authors at 1 institution in 1 country.

Maddalena Alessandra WuDivision of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Emanuele CatenaDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Antonio CastelliDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Roberto RechDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Beatrice BorghiDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Davide OttolinaDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Tommaso FossaliDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Chiara CogliatiDivision of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.
Riccardo ColomboDivision of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital-Polo Universitario-University of Milan, Milan, Italy.ORCID 0000-0002-9616-803X
University of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe term Idiopathic Systemic Capillary Leak Syndrome (ISCLS) refers to an uncommon condition of severe distributive shock, resulting from an abrupt shift of fluids and proteins from the intravascular to the interstitial compartment. We hypothesise that the autonomic nervous system (ANS) fails in regulating the response to hypovolemia in acute ISCLS and that ANS variables characterise the progression to the recovery.

designProspective cohort study of patients admitted to ICU for severe ISCLS flares.

settingSingle, referral center in Italy for ISCLS. PATIENTS: Analysis of cardiovascular signals recorded during seven severe ISCLS attacks and one prodromal period in five patients.

interventionsANS was studied non-invasively by means of heart rate variability (HRV) and blood pressure variability analysis, as an estimation of vagal and sympathetic modulation directed to the heart and vessels. Heart rate and systolic arterial pressure (SAP) variability were also used to assess baroreflex sensitivity. ANS variables were measured during the subsequent phases which characterise ISCLS flares, namely the acute phase, the post-acute phase, and the recovery phase. MEASUREMENTS AND MAIN

resultsHRV was severely depressed during the acute phase accounting for the loss of ANS modulation during massive capillary extravasation. This phase was characterised by shock and impaired baroreflex control, which allowed SAP to oscillate driven by respiratory activity. Impending shock and transition from shock to a post-acute phase were marked by change of baroreflex spectral variables. The baroreflex control was fully restored during recovery.

conclusionsANS modulation and baroreflex control are severely impaired during the acute haemodynamic instability which characterises ISCLS crises and their progressive restoration may be a clue of improvement. ANS indices during ISCLS flares might serve as useful biomarkers, able to timely announce the transition from one phase to the subsequent one, thus helping to adapt therapy accordingly.

Indexed as

Autonomic Nervous SystemBaroreflexBiomarkersCapillary Leak SyndromeHeart RateShockAdultAgedBlood PressureFemaleHumansMaleMiddle AgedProspective StudiesBiomarkers

Identifiers

PMID34061871
PMCPMC8168872
OpenAlexW3165095896

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.