Evidence map›Paper›PMID 36294844›Full record

ArticleJournal of personalized medicine2022

The Cardiac Power Index during Abdominal Open Aortic Surgery: Intraoperative Insights into the Cardiac Performance-A Retrospective Observational Analysis.

Fulvio Nisi, Enrico Giustiniano, Massimo Meco, Luca Pugliese, Lorenzo Calabrò, Sofia Spano, Umberto Ripani, Maurizio Cecconi

Registry-linked trialAbstract read
In one paragraph

Article in Journal of personalized medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07037225 (Hemodynamic Changes in Left and Right Lateral Position During One Lung Ventilation), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT07037225 naactive not recruitingnot on this mapstarted 2025, after this paper: background citation

Hemodynamic Changes in Left and Right Lateral Position During One Lung Ventilation

TypeinterventionalSponsorMaria FountoulakiRan2025 to 2027Enrolled60ConditionsThoracic Surgical Procedures, One-lung Ventilation (OLV), Hemodynamic ChangesArmsFluid challenge during one-lung ventilation (OLV) in the lateral decubitus position, Hemodynamic monitoring
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

8 authors.

Fulvio NisiDepartment of Anesthesia, Intensive Care Unit and Pain Therapy, IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Milan, Italy.ORCID 0000-0003-1975-5473
Enrico GiustinianoDepartment of Anesthesia, Intensive Care Unit and Pain Therapy, IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Milan, Italy.
Massimo MecoDepartment of Anesthesia and Intensive Care, Humanitas Gavazzeni Clinics, Via Mauro Gavazzeni 21, 24125 Bergamo, Italy.
Luca PuglieseDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy.
Lorenzo CalabròDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy.ORCID 0000-0001-5389-5344
Sofia SpanoDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy.
Umberto RipaniDivision of Clinic Anaesthesia, Department of Emergency Hospital Riuniti, Conca Street 71, 60126 Ancona, Italy.
Maurizio CecconiDepartment of Anesthesia, Intensive Care Unit and Pain Therapy, IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The Cardiac Power Index (CPI) measures the rate of energy output generated by the heart and correlates this with in-hospital mortality due to cardiogenic shock. In open aortic surgery, both aortic clamping and unclamping expose the heart to abrupt variations of the left ventricle afterload, preload, and contractility, with possible hemodynamic impairment. We investigated how aortic-cross clamping (Ao-XC) and unclamping (Ao-UC) procedures affect the CPI during open aortic surgery. Methods: We retrospectively analyzed our surgical database of 67 patients submitted to open surgical aortic repair at Humanitas Research Hospital, Milan. Patients were monitored by an EV1000-FloTrac SystemTM (Edwards Lifescience, Irvine, CA, USA) beyond the standard intra-operative hemodynamic monitoring. The primary outcome was the variation of basal CPI after aortic clamping and unclamping. Secondary outcomes were variations of the cardiac index (CI), mean arterial pressure (MAP), heart rate, and lactate during aortic clamping and after unclamping. The CPI was computed as: (CI × MAP)/451. Results: The CPI changed significantly after aortic unclamping. CPI: basal = 0.39 ± 0.1 W/m2, after Ao-XC = 0.39 ± 0.1 W/m2, and after Ao-UC = 0.44 ± 0.2 W/m2, p < 0.05. The CI changed during both cross-clamping and unclamping (p < 0.0001), whilst the MAP and heart rate did not during any phase of the surgery. Five subjects (8.3%) needed inotropic support after cross-clamping. Their basal CPI was lower than the general population: 0.31 ± 0.11 W/m2 vs. 0.39 ± 0.1 W/m2. Conclusions: The CPI describes the adaptation of the cardiac function to the changes in preload, contractility, and afterload occurring during aortic cross-clamping and unclamping. It may be used to explore the cardiac performance in real-time and predict cardiac impairment in the intraoperative period in a minimally invasive way, similar to ventriculo-arterial coupling parameters.

Indexed as

aortic open repaircardiac outputhemodynamic monitoringvascular surgeryventriculo-arterial coupling

Identifiers

PMID36294844
PMCPMC9605046

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Registered trials

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.