Evidence map›Paper›PMID 34087418›Full record

Trial reportResuscitation2021

Glycopyrrolate does not ameliorate hypothermia associated bradycardia in healthy individuals: A randomized crossover trial.

Jon C Rittenberger, Alexandra Weissman, Katharyn L Flickinger, Francis X Guyette, David Hopkins, Melissa J Repine, Cameron Dezfulian, Ankur A Doshi, Jonathan Elmer, Kelly N Sawyer and 1 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 25% 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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Experimental hypothermia by cold air: a randomized, double-blind, placebo-controlled crossover trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025
    Trial
  2. Article
  3. 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.

Jon C RittenbergerRobert Packer Hospital Emergency Medicine Residency, Sayre, PA, United States; Geisinger Commonwealth School of Medicine, Scranton, PA, United States; University of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States. Electronic address: Jon.Rittenberger@guthrie.org.
Alexandra WeissmanUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
Katharyn L FlickingerUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
Francis X GuyetteUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
David HopkinsGeisinger Commonwealth School of Medicine, Scranton, PA, United States.
Melissa J RepineUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
Cameron DezfulianUniversity of Pittsburgh Department of Critical Care Medicine, Pittsburgh, PA, United States.
Ankur A DoshiUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
Jonathan ElmerUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States; University of Pittsburgh Department of Critical Care Medicine, Pittsburgh, PA, United States.
Kelly N SawyerUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
Clifton W CallawayUniversity of Pittsburgh Department of Emergency Medicine, Pittsburgh, PA, United States.
University of Pittsburgh · USGeisinger Commonwealth School of Medicine · US

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
Quantitative electroencephalography after cardiac arrestK23NS097629 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ELMER, JONATHAN · 2017 to 2021
$945k
NCATS NIH HHS UL1 TR001857NINDS NIH HHS K23 NS097629
6 · The paper itself

Abstract

backgroundHypothermia improves outcomes following ischemia-reperfusion injury. Shivering is common and can be mediated by agents such as dexmedetomidine. The combination of dexmedetomidine and hypothermia results in bradycardia. We hypothesized that glycopyrrolate would prevent bradycardia during dexmedetomidine-mediated hypothermia.

methodsWe randomly assigned eight healthy subjects to premedication with a single 0.4 mg glycopyrrolate intravenous (IV) bolus, titrated glycopyrrolate (0.01 mg IV every 3 min as needed for heart rate <50), or no glycopyrrolate during three separate sessions of 3 h cooling. Following 1 mg/kg IV dexmedetomidine bolus, subjects received 20 ml/kg IV 4 °C saline and surface cooling (EM COOLS, Weinerdorf, Austria). We titrated dexmedetomidine infusion to suppress shivering but permit arousal to verbal stimuli. After 3 h of cooling, we allowed subjects to passively rewarm. We compared heart rate, core temperature, mean arterial blood pressure, perceived comfort and thermal sensation between groups using Kruskal-Wallis test and ANOVA.

resultsMean age was 27 (SD 6) years and most (N = 6, 75%) were male. Neither heart rate nor core temperature differed between the groups during maintenance of hypothermia (p > 0.05). Mean arterial blood pressure was higher in the glycopyrrolate bolus condition (p < 0.048). Thermal sensation was higher in the control condition than the glycopyrrolate bolus condition (p = 0.01). Bolus glycopyrrolate resulted in less discomfort than titrated glycopyrrolate (p = 0.04).

conclusionsGlycopyrrolate did not prevent the bradycardic response to hypothermia and dexmedetomidine. Mean arterial blood pressure was higher in subjects receiving a bolus of glycopyrrolate before induction of hypothermia. Bolus glycopyrrolate was associated with less intense thermal sensation and less discomfort during cooling.

Indexed as

BradycardiaDexmedetomidineGlycopyrrolateHypothermiaAdultAustriaCross-Over StudiesFemaleHumansMaleYoung AdultDexmedetomidineGlycopyrrolateGlycopyrrolateHypothermiaResuscitationTorpor

Identifiers

PMID34087418
PMCPMC8259805
OpenAlexW3165707332

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.