Evidence map›Paper›PMID 35798633›Full record

Trial reportJournal of cardiothoracic and vascular anesthesia2022

Anesthetics to Prevent Lung Injury in Cardiac Surgery: A Randomized Controlled Trial.

Brian P O'Gara, Shahzad Shaefi, Doris V Gasangwa, Melissa Patxot, Najla Beydoun, Ariel L Mueller, Iftach Sagy, Victor Novack, Valerie M Banner-Goodspeed, Abirami Kumaresan and 9 more

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of cardiothoracic and vascular anesthesia, 2022. 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
0.5field-weighted citation impact, top 37% 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, 3 citations in OpenAlex.

  1. Review
  2. Observational
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

19 authors at 6 institutions in 2 countries.

Brian P O'GaraBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA. Electronic address: bpogara@bidmc.harvard.edu.
Shahzad ShaefiBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Doris V GasangwaBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Melissa PatxotBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Najla BeydounBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Ariel L MuellerMassachusetts General Hospital, Department of Anesthesia, Boston, MA.
Iftach SagyClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
Victor NovackClinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
Valerie M Banner-GoodspeedBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Abirami KumaresanKeck Medical Center, Department of Anesthesiology, Los Angeles, CA.
Alexander ShapetonVeterans Affairs Boston Healthcare, West Roxbury, MA.
Kyle SpearBeth Israel Deaconess Medical Center, Department of Perfusion, Boston, MA.
Somnath BoseBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Elias N Baedorf KassisBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Andre F GoslingDuke University Medical Center, Department of Anesthesia, Raleigh, NC.
Feroze-Ud-Den MahmoodBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Kamal KhabbazBeth Israel Deaconess Medical Center, Department of Surgery, Division of Cardiac Surgery, Boston, MA.
Balachundhar SubramaniamBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Daniel S TalmorBeth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA.
Beth Israel Deaconess Medical Center · USSoroka Medical Center · ILDuke Medical Center · USKeck Hospital of USC · USMassachusetts General Hospital · USVA Boston Healthcare System · US

Funding

Scheduled Prophylactic 6-hourly IV Acetaminophen to Prevent Postoperative Delirium in Older Cardiac Surgical Patients (PANDORA) - EEG Administrative SupplementR01AG065554 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R, SUBRAMANIAM, BALACHUNDHAR · 2019 to 2025
$7.4M
Sepsis and the benefits of permissive hypoxiaK08GM134220 · NIGMS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SHAEFI, SHAHZAD · 2019 to 2022
$775k
NHLBI NIH HHS L30 HL138811NIA NIH HHS R01 AG065554NIGMS NIH HHS K08 GM134220
6 · The paper itself

Abstract

objectivesTo investigate if sevoflurane based anesthesia is superior to propofol in preventing lung inflammation and preventing postoperative pulmonary complications.

designRandomized controlled trial.

settingSingle tertiary care university hospital.

participantsForty adults undergoing cardiac surgery with cardiopulmonary bypass.

interventionsPatients were randomized in a 1:1 ratio to anesthetic maintenance with sevoflurane or propofol. MEASUREMENTS AND MAIN

resultsBlood and bronchoalveolar lavage fluid was sampled before and after bypass to measure pulmonary inflammation using a biomarker panel. The change in bronchoalveolar lavage concentration of tumor necrosis factor alpha (TNFα) was the primary outcome. Secondary outcomes included lung inflammation defined as changes in other biomarkers and postoperative pulmonary complications. There were no significant differences between groups in the change in bronchoalveolar lavage TNFα concentration (median [IQR] change, 17.24 [1.11-536.77] v 101.51 [1.47-402.84] pg/mL, sevoflurane v propofol, p = 0.31). There was a significantly lower postbypass concentration of plasma interleukin 8 (median [IQR], 53.92 [34.5-55.91] v 66.92 [53.03-94.44] pg/mL, p = 0.04) and a significantly smaller postbypass increase in the plasma receptor for advanced glycosylation end products (median [IQR], 174.59 [73.59-446.06] v 548.22 [193.15-852.39] pg/mL, p = 0.03) in the sevoflurane group compared with propofol. The incidence of postoperative pulmonary complications was 100% in both groups, with high rates of pleural effusion (17/18 [94.44%] v 19/22 [86.36%], p = 0.39) and hypoxemia (16/18 [88.88%] v 22/22 [100%], p = 0.11).

conclusionsSevoflurane anesthesia during cardiac surgery did not consistently prevent lung inflammation or prevent postoperative pulmonary complications compared to propofol. There were significantly lower levels of 2 plasma biomarkers specific for lung injury and inflammation in the sevoflurane group.

Indexed as

Anesthetics, InhalationCardiac Surgical ProceduresLung InjuryMethyl EthersPneumoniaPropofolAdultAnesthetics, IntravenousBiomarkersHumansPostoperative ComplicationsSevofluraneTumor Necrosis Factor-alphaAnesthetics, InhalationAnesthetics, IntravenousBiomarkersMethyl EthersPropofolSevofluraneTumor Necrosis Factor-alpha

Identifiers

PMID35798633
PMCPMC9728032
OpenAlexW4224293590

What OpenQuestion holds

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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.