Evidence map›Paper›PMID 34096120›Full record

SynthesisTransfusion medicine (Oxford, England)2021

The effect of non-point-of-care haemostasis management protocol implementation in cardiac surgery: A systematic review.

Reinier P J Boxma, Robert P Garnier, Carolien S E Bulte, Michael I Meesters

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Transfusion medicine (Oxford, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 62% 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

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

  1. Pooled it
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 3 institutions in 1 country.

Reinier P J BoxmaDepartment of Anesthesiology, Amsterdam University Medical Center, Location VU Medical Center, Amsterdam, The Netherlands.
Robert P GarnierDepartment of Anesthesiology, Amsterdam University Medical Center, Location VU Medical Center, Amsterdam, The Netherlands.
Carolien S E BulteDepartment of Anesthesiology, Amsterdam University Medical Center, Location VU Medical Center, Amsterdam, The Netherlands.
Michael I MeestersDepartment of Anesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
Amsterdam UMC Location VUmc · NLAmsterdam University Medical Centers · NLCatharina Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis systematic review aims to outline the evidence on the implementation of a non-point-of-care (non-point-of-care [POC]) haemostasis management protocol compared to experience-based practice in adult cardiac surgery.

backgroundManagement of coagulopathy in cardiac surgery is complex and remains highly variable among centres and physicians. Although various guidelines recommend the implementation of a transfusion protocol, the literature on this topic has never been systematically reviewed.

methodsPubMed, Embase, Cochrane Library, and Web of Science were searched from January 2000 till May 2020.

resultsA total of seven studies (one randomised controlled trial [RCT], one prospective cohort study, and five retrospective studies) met the inclusion criteria. Among the six non-randomised, controlled studies, the risk of bias was determined to be serious to critical, and the one RCT was determined to have a high risk of bias. Five studies showed a significant reduction in red blood cells, fresh frozen plasma, and/or platelet transfusion after the implementation of a structural non-POC algorithm, ranging from 2% to 28%, 2% to 19.5%, and 7% to17%, respectively. One study found that fewer patients required transfusion of any blood component in the protocol group. Another study had reported a significantly increased transfusion rate of platelet concentrate in the haemostasis algorithm group.

conclusionOwing to the high heterogeneity and a substantial risk of bias of the included studies, no conclusion can be drawn on the additive value of the implementation of a cardiac-surgery-specific non-POC transfusion and haemostasis management algorithm compared to experience-based practice. To define the exact impact of a transfusion protocol on blood product transfusion, bleeding, and adverse events, well-designed prospective clinical trials are required.

Indexed as

Blood Coagulation DisordersCardiac Surgical ProceduresClinical ProtocolsHemorrhageHemostasisHumansPlatelet TransfusionRandomized Controlled Trials as Topiccardiac surgeryhaemostasisprotocoltransfusion

Identifiers

PMID34096120
PMCPMC8597010
OpenAlexW3171650241

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.