Evidence map›Paper›PMID 35964137›Full record

Trial reportTrials2022

Evaluation of the recovery after heart surgery following preoperative supplementation with a combination of beta-hydroxy-beta-methylbutyrate, L-arginine, and L-glutamine: a double-blind randomized placebo-controlled clinical trial.

Mona Norouzi, Azadeh Nadjarzadeh, Majid Maleki, Sayyed Saeid Khayyatzadeh, Saeid Hosseini, Mehdi Yaseri, Hamed Fattahi

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
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  4. Review
  5. Article
  6. Article
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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

7 authors at 4 institutions in 1 country.

Mona NorouziNutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam BLD., ALEM square, Yazd, Iran.
Azadeh NadjarzadehNutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam BLD., ALEM square, Yazd, Iran. Azadehnajarzadeh@Gmail.com.
Majid MalekiRajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Sayyed Saeid KhayyatzadehNutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye gomnam BLD., ALEM square, Yazd, Iran.
Saeid HosseiniHeart Valve Disease Research Center, Shahid Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Mehdi YaseriDepartment of Epidemiology and Biostatistics, Tehran University of Medical Science, Tehran, Iran.
Hamed FattahiCardiovascular Medical and Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shahid Sadoughi University of Medical Sciences and Health Services · IRShaheed Rajaei Cardiovascular Medical and Research Center · IRShahid Beheshti University of Medical Sciences · IRUniversity of Tehran · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe preoperative period is a good time to improve nutrition status, compensate for nutrient deficiencies, and optimize immune function in patients' underlying surgery. In some medical conditions, supplementation with a combination of L-glutamine (Gln), β-hydroxy-β-methylbutyrate (HMB), and L-arginine (Arg) had promising effects on improving recovery. The present study aimed to evaluate the effect of supplementation with Gln/Arg/HMB in patients undergoing heart surgery.

methodsThis randomized clinical trial was conducted on 70 patients undergoing cardiac surgery. Participants were requested to consume 2 sachets of a combination of 7 g L-arginine, 7 g L-glutamine, and 1.5 g daily HMB or placebo 30 days before operation. At the baseline and end of the study, left ventricular ejection fraction and the serum levels of troponin, creatine phosphokinase (CPK), CPK-MB, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin were measured. Also, the Sequential Organ Failure Assessment (SOFA) score, time of stay in hospital and intensive care unit (ICU), and postoperative complications were recorded after surgery.

resultsIn total, 60 preoperative patients (30 in each group) with a mean age of 53.13 ± 14.35 years completed the study (attrition rate = 85.7%). Subjects in the Gln/Arg/HMB group had lower serum levels of CPK-MB (median [IQR] = 49 [39.75] vs. 83 [64.55]; P = 0.011), troponin (median [IQR] = 2.13 [1.89] vs. 4.34 [1.99]; P < 0.001), bilirubin (median [IQR] = 0.50 [0.20] vs. 0.40 [0.22]; P < 0.001), and SOFA score (median [IQR] = 2 [2] vs. 5 [2]; P < 0.001) at end of the study compared to the placebo. Also, the time of stay in the hospital (median [IQR] = 5 [1] vs. 6 [3]; P < 0.001) and ICU (median [IQR] = 2.50 [1.00] vs. 3.50 [1.50]; P = 0.002) was lower in the Gln/Arg/HMB group.

conclusionThe present study showed that perioperative supplementation with a combination of Gln, Arg, and HMB enhances the recovery, reduces myocardial injury, and decreases the time of hospital and ICU stay in cardiac surgery patients. These results need to be confirmed in a larger trial.

trial registrationIRCT.ir IRCT20120913010826N31. Registered on 13 October 2020.

Indexed as

Cardiac Surgical ProceduresGlutamineAdultAgedArginineBilirubinDietary SupplementsHumansMiddle AgedStroke VolumeTroponinValeratesVentricular Function, LeftArgininebeta-hydroxyisovaleric acidBilirubinGlutamineTroponinValeratesArginineBeta-hydroxy-beta-methylbutyrateGlutamineHeart surgeryHMBRecovery

Identifiers

PMID35964137
PMCPMC9375058
OpenAlexW4291168562

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.