Evidence map›Paper›PMID 36799559›Full record

Trial reportEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2023

Warm versus cold blood cardioplegia in paediatric congenital heart surgery: a randomized trial.

Serban Stoica, Helena J M Smartt, Rachael Heys, Karen Sheehan, Terrie Walker-Smith, Andrew Parry, Richard Beringer, Iakovos Ttofi, Rebecca Evans, Lucy Dabner and 6 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 32% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 1 country.

Serban StoicaBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Helena J M SmarttBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0001-5285-2262
Rachael HeysBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.
Karen SheehanBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Terrie Walker-SmithBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.
Andrew ParryBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Richard BeringerBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Iakovos TtofiBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Rebecca EvansBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-7119-8187
Lucy DabnerBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.
Mohamed T GhorbelBristol Heart Institute, University of Bristol, Bristol, UK.
William LansdowneBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Barnaby C ReevesBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.
Gianni D AngeliniNational Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.ORCID 0000-0002-1753-3730
Chris A RogersBristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-9624-2615
Massimo CaputoBristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.ORCID 0000-0001-7508-0891
University Hospitals Bristol NHS Foundation Trust · GBUniversity of Bristol · GB

Funding

British Heart Foundation CH/17/1/32804British Heart Foundation CH/1992027/7163British Heart Foundation PG/14/72/31080British Heart Foundation PG/15/33/31394/BHF
6 · The paper itself

Abstract

objectivesIntermittent cold blood cardioplegia is commonly used in children, whereas intermittent warm blood cardioplegia is widely used in adults. We aimed to compare clinical and biochemical outcomes with these 2 methods.

methodsA single-centre, randomized controlled trial was conducted to compare the effectiveness of warm (≥34°C) versus cold (4-6°C) antegrade cardioplegia in children. The primary outcome was cardiac troponin T over the 1st 48 postoperative hours. Intensive care teams were blinded to group allocation. Outcomes were compared by intention-to-treat using linear mixed-effects, logistic or Cox regression.

results97 participants with median age of 1.2 years were randomized (49 to warm, 48 to cold cardioplegia); 59 participants (61%) had a risk-adjusted congenital heart surgery score of 3 or above. There were no deaths and 92 participants were followed to 3-months. Troponin release was similar in both groups [geometric mean ratio 1.07; 95% confidence interval (CI) 0.79-1.44; P = 0.66], as were other cardiac function measures (echocardiography, arterial and venous blood gases, vasoactive-inotrope score, arrhythmias). Intensive care stay was on average 14.6 h longer in the warm group (hazard ratio 0.52; 95% CI 0.34-0.79; P = 0.003), with a trend towards longer overall hospital stays (hazard ratio 0.66; 95% CI 0.43-1.02; P = 0.060) compared with the cold group. This could be related to more unplanned reoperations on bypass in the warm group compared to cold group (3 vs 1).

conclusionsWarm blood cardioplegia is a safe and reproducible technique but does not provide superior myocardial protection in paediatric heart surgery.

Indexed as

Cardiac Surgical ProceduresHeart Defects, CongenitalChildCoronary Artery BypassHeartHeart Arrest, InducedHumansInfantCardiac surgeryCardioplegia temperatureCardiopulmonary bypassClinical trialsPaediatricsRandomized

Identifiers

PMID36799559
PMCPMC10097434
OpenAlexW4321153061

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.