Evidence map›Paper›PMID 34598966›Full record

ArticleBMJ case reports2021

Dynamic right-to-left interatrial shunt may complicate severe COVID-19.

Rajkumar Rajendram, Arif Hussain, Naveed Mahmood, Gabriele Via

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 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
1.3field-weighted citation impact, top 18% 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, 9 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

4 authors at 3 institutions in 2 countries.

Rajkumar RajendramDepartment of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia rajkumarrajendram@doctors.org.uk.ORCID http://orcid.org/0000-0001-7790-4591
Arif HussainDepartment of Cardiovascular Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Naveed MahmoodDepartment of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Gabriele ViaDepartment of Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland.
King Saud bin Abdulaziz University for Health Sciences · SAEpatocentro Ticino · CHKing Abdulaziz Medical City · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Right-to-left (RTL) interatrial shunt (IAS) may complicate select cases of COVID-19 pneumonia. We describe the use of serial imaging to monitor shunt in critically ill patients. A 52-year-old man presented with COVID-19 pneumonia. Hypoxia worsened despite maximal medical therapy and non-invasive ventilation. On day 8, saline microbubble contrast-enhanced transthoracic echocardiography revealed a patent foramen ovale (PFO) with RTLIAS. Invasive ventilation was initiated the next day. The course was complicated by intermittent severe desaturation without worsening aeration or haemodynamic instability, so PFO closure was considered. However, on day 12, saline microbubble contrast-enhanced transoesophageal echocardiography excluded RTLIAS. The patient was extubated on day 27 and discharged home 12 days later. Thus, RTLIAS may be dynamic and changes can be detected and monitored by serial imaging. Bedside echocardiography with saline microbubble contrast, a simple, minimally invasive bedside test, may be useful in the management of patients with severe hypoxia.

Indexed as

COVID-19Foramen Ovale, PatentEchocardiographyEchocardiography, TransesophagealHumansMaleMiddle AgedSARS-CoV-2adult intensive careCOVID-19mechanical ventilationpneumonia (respiratory medicine)

Identifiers

PMID34598966
PMCPMC8488708
OpenAlexW3203025586

What OpenQuestion holds

Textmetadata
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.