Evidence map›Paper›PMID 37285112›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2023

A case of recurring perioperative circulatory arrest: mind the autonomic nervous system.

Ulrich Limper, Dorothee Keipke, Lars Lindenbeck, Friederike Lanz, Claudia Kramer, Axel Meissner, Frank Wappler, Thorsten Annecke

Abstract readCase ReportsLetter
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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.

Ulrich LimperDepartment of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Straße 200, 51109, Cologne, Germany. limperu@kliniken-koeln.de.ORCID 0000-0001-9927-4180
Dorothee KeipkeDepartment of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Straße 200, 51109, Cologne, Germany.
Lars LindenbeckDepartment of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Straße 200, 51109, Cologne, Germany.
Friederike LanzDepartment of Cardiology, Merheim Medical Center, Cologne, Germany.
Claudia KramerDepartment of Cardiology, Merheim Medical Center, Cologne, Germany.
Axel MeissnerDepartment of Cardiology, Merheim Medical Center, Cologne, Germany.
Frank WapplerDepartment of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Straße 200, 51109, Cologne, Germany.
Thorsten AnneckeDepartment of Anaesthesiology and Critical Care Medicine, Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Straße 200, 51109, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report the case of an elderly woman who developed recurring episodes of unexplained cardiocirculatory arrest. The index event appeared during surgery to fix a fracture of the ankle and consisted of bradypnea, hypotension and asystole, coherent with a Bezold-Jarisch-like cardioprotective reflex. Classical signs of acute myocardial infarction were absent. Yet, occlusion of the right coronary artery (RCA) was observed and successfully revascularized, whereupon circulatory arrests vanished. We discuss several differential diagnoses. Unexplainable circulatory failure, with sinus bradycardia and arterial hypotension, despite lack of ECG signs of ischemia or significant troponin levels, suggest the action of cardioprotective reflexes of the autonomic nervous system. Coronary artery disease is a common source. Attention to cardioprotective reflexes should be taken in the case of unexplained cardiac arrest without overt reasons. We recommend performing coronary angiography to exclude significant coronary stenosis.

Indexed as

Heart ArrestHypotensionMyocardial InfarctionAgedAutonomic Nervous SystemFemaleHumansReflexAnaesthesiaAutonomic nervous systemCardiopulmonary resuscitationPerioperativeRight bundle branch blockSympathicusVagus nerve

Identifiers

PMID37285112
PMCPMC10439036

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.