Evidence map›Paper›PMID 34242347›Full record

ArticlePloS one2021

Maintaining oxygen delivery is crucial to prevent intestinal ischemia in critical ill patients.

Jochen J Schoettler, Thomas Kirschning, Michael Hagmann, Bianka Hahn, Anna-Meagan Fairley, Franz-Simon Centner, Verena Schneider-Lindner, Florian Herrle, Emmanouil Tzatzarakis, Manfred Thiel and 1 more

Abstract read
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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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. 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.

Jochen J SchoettlerDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.ORCID 0000-0003-2408-6884
Thomas KirschningClinic for Thorax- and Cardiovascular Surgery HDZ NRW, University of Ruhr-University Bochum, Bochum, Germany.
Michael HagmannInterdisciplinary Center for Scientific Computing, Heidelberg University, Heidelberg, Germany.
Bianka HahnDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Anna-Meagan FairleyDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Franz-Simon CentnerDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Verena Schneider-LindnerDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Florian HerrleSurgical Department, University Medical Center Mannheim, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Emmanouil TzatzarakisSurgical Department, University Medical Center Mannheim, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.ORCID 0000-0002-3554-1160
Manfred ThielDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
Joerg KrebsDepartment of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntestinal ischemia is a common complication with obscure pathophysiology in critically ill patients. Since insufficient delivery of oxygen is discussed, we investigated the influence of oxygen delivery, hemoglobin, arterial oxygen saturation, cardiac index and the systemic vascular resistance index on the development of intestinal ischemia. Furthermore, we evaluated the predictive power of elevated lactate levels for the diagnosis of intestinal ischemia.

methodsIn a retrospective case-control study data (mean oxygen delivery, minimum oxygen delivery, systemic vascular resistance index) of critical ill patients from 02/2009-07/2017 were analyzed using a proportional hazard model. General model fit and linearity were tested by likelihood ratio tests. The components of oxygen delivery (hemoglobin, arterial oxygen saturation and cardiac index) were individually tested in models.

results59 out of 874 patients developed intestinal ischemia. A mean oxygen delivery less than 250ml/min/m2 (LRT vs. null model: p = 0.018; LRT for non-linearity: p = 0.012) as well as a minimum oxygen delivery less than 400ml/min/m2 (LRT vs null model: p = 0.016; LRT for linearity: p = 0.019) were associated with increased risk of the development of intestinal ischemia. We found no significant influence of hemoglobin, arterial oxygen saturation, cardiac index or systemic vascular resistance index. Receiver operating characteristics analysis for elevated lactate levels, pH, CO2 and central venous saturation was poor with an area under the receiver operating characteristic of 0.5324, 0.52, 0.6017 and 0.6786.

conclusionThere was a significant correlation for mean and minimum oxygen delivery with the incidence of intestinal ischemia for values below 250ml/min/m2 respectively 400ml/min/m2. Neither hemoglobin, arterial oxygen saturation, cardiac index, systemic vascular resistance index nor elevated lactate levels could be identified as individual risk factors.

Indexed as

Critical IllnessIntestinesIschemiaOxygenAgedCase-Control StudiesFemaleHemoglobinsHumansLactic AcidMaleMiddle AgedOxygen SaturationRetrospective StudiesVascular ResistanceHemoglobinsLactic AcidOxygen

Identifiers

PMID34242347
PMCPMC8270469

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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.