Evidence map›Paper›PMID 37038219›Full record

ReviewPerioperative medicine (London, England)2023

Efficacy of remote ischaemic preconditioning on outcomes following non-cardiac non-vascular surgery: a systematic review and meta-analysis.

Aikaterini Papadopoulou, Matthew Dickinson, Theophilus L Samuels, Christian Heiss, Lui Forni, Ben Creagh-Brown

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Perioperative medicine (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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.

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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. 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

6 authors.

Aikaterini PapadopoulouDepartment of Anesthesia, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. aikaterini.papadopoulou@nhs.net.ORCID http://orcid.org/0000-0003-2707-3632
Matthew DickinsonDepartment of Anesthesia, Royal Surrey County Hospital, Guildford, UK.
Theophilus L SamuelsDepartment of Critical Care, Surrey and Sussex Healthcare NHS Trust, Redhill, UK.
Christian HeissVascular Department, Surrey and Sussex Healthcare NHS Trust, Redhill, UK.
Lui ForniDepartment of Critical Care, Royal Surrey County Hospital, Guildford, UK.
Ben Creagh-BrownDepartment of Critical Care, Royal Surrey County Hospital, Guildford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRemote ischaemic preconditioning (RIPC) has been investigated as a simple intervention to potentially mitigate the ischaemic effect of the surgical insult and reduce postoperative morbidity. This review systematically evaluates the effect of RIPC on morbidity, including duration of hospital stay and parameters reflective of cardiac, renal, respiratory, and hepatic dysfunction following non-cardiac non-vascular (NCNV) surgery.

methodsThe electronic databases PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from their inception date to November 2021. Studies investigating the effect of local preconditioning or postconditioning were excluded. Methodological quality and risk of bias were determined according to the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2). Calculation of the odds ratios and a random effects model was used for dichotomous outcomes and mean differences or standardised mean differences as appropriate were used for continuous outcomes. The primary outcomes of interest were cardiac and renal morbidity, and the secondary outcomes included other organ function parameters and hospital length of stay.

resultsA systematic review of the published literature identified 36 randomised controlled trials. There was no significant difference in postoperative troponin or acute kidney injury. RIPC was associated with lower postoperative serum creatinine (9 studies, 914 patients, mean difference (MD) - 3.81 µmol/L, 95% confidence interval (CI) - 6.79 to - 0.83, p = 0.01, I

conclusionsThis meta-analysis did not show an improvement in the primary outcomes of interest with the use of RIPC. RIPC was associated with a small improvement in certain surrogate parameters of organ function and small reduction in hospital length of stay. Our results should be interpreted with caution due to the limited number of studies addressing individual outcomes and the considerable heterogeneity identified.

trial registrationPROSPERO CRD42019129503.

Indexed as

Ischaemic preconditioningNon-cardiac surgeryPostoperative acute kidney injuryPostoperative morbidityPostoperative myocardial injuryPostoperative troponin

Identifiers

PMID37038219
PMCPMC10084674

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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.