Evidence map›Paper›PMID 37244820›Full record

Observational studyJournal of cardiothoracic and vascular anesthesia2023

Effects of Postoperative Blood Pressure Management on Delirium Among Patients in the Intensive Care Unit After Cardiac Surgery: An Observational Cohort Study.

Andrew J Schaffer, Gen Li, David R McIlroy, Marcos G Lopez, Robert E Freundlich

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Journal of cardiothoracic and vascular anesthesia, 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
0.6field-weighted citation impact, top 34% 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, 3 citations in OpenAlex.

  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

5 authors at 3 institutions in 2 countries.

Andrew J SchafferVanderbilt University School of Medicine, Nashville, Tennessee.
Gen LiDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
David R McIlroyDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Anaesthesia & Perioperative Medicine, Monash University, Melbourne, Australia.
Marcos G LopezDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Robert E FreundlichDepartment of Anesthesiology, Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: robert.e.freundlich@vumc.org.
Vanderbilt University Medical Center · USMonash University · AUVanderbilt University · US

Funding

The effects of soluble guanylyl cyclase stimulation on perioperative vascular reactivity and organ injury in cardiac surgery trialR01HL164909 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Marcos G Lopez · 2022 to 2026
$2.2M
Reducing Reintubation Risk in High-Risk Cardiac Surgery Patients with High-Flow Nasal Cannula -the "I-CAN" studyK23HL148640 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI FREUNDLICH, ROBERT EDWARD · 2020 to 2024
$867k
Perioperative Oxygenation, Endothelial Dysfunction, and Organ Injury in Cardiac SurgeryK23GM129662 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI LOPEZ, MARCOS G · 2018 to 2022
$764k
NHLBI NIH HHS K23 HL148640NHLBI NIH HHS R01 HL164909NIGMS NIH HHS K23 GM129662
6 · The paper itself

Abstract

objectivesThis study aimed to determine whether blood pressure control in the early postoperative period was associated with postoperative delirium in the cardiovascular intensive care unit (ICU).

designObservational cohort study.

settingSingle large academic institution with a high volume of cardiac surgery.

participantsCardiac surgery patients admitted to the cardiovascular ICU after surgery.

interventionsObservational study. MEASUREMENTS AND MAIN

resultsA total of 517 cardiac surgery patients had mean arterial pressure (MAP) data recorded minute-by-minute for 12 postoperative hours. The time spent in each of the 7 prespecified blood pressure bands was calculated, and the development of delirium was recorded in the ICU. A multivariate Cox regression model was developed using the least absolute shrinkage and selection operator approach to identify associations between time spent in each MAP range band and delirium. Compared with the reference band of 60-to-69 mmHg, longer durations spent in 3 bands were independently associated with a lower risk of delirium: 50-to-59 mmHg band (adjusted hazard ratio [HR] 0.907 [per 10 minutes]; 95% CI 0.861-0.955); 70-to-79 mmHg band (adjusted HR 0.923 [per 10 minutes]; 95% CI 0.902-0.944); 90-to-99 mmHg band (adjusted HR 0.898 [per 10 minutes]; 95% CI 0.853-0.945).

conclusionsThe MAP range bands above and below the authors' reference band of 60-to- 69 mmHg were associated with decreased risk of ICU delirium development; however, this was difficult to reconcile with a plausible biologic mechanism. Therefore, the authors did not find a correlation between early postoperative MAP control and increased risk of the development of ICU delirium after cardiac surgery.

Indexed as

Cardiac Surgical ProceduresDeliriumBlood PressureCohort StudiesHumansIntensive Care UnitsPostoperative ComplicationsRisk Factorsblood pressurecardiac surgerycardiovascular ICUdelirium prevention

Identifiers

PMID37244820
PMCPMC10524613
OpenAlexW4376116636

What OpenQuestion holds

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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.