Evidence map›Paper›PMID 38690427›Full record

Trial reportJTCVS open2024

Bilateral remote ischemic conditioning in children: A two-center, double-blind, randomized controlled trial in young children undergoing cardiac surgery.

Nigel E Drury, Carin van Doorn, Rebecca L Woolley, Rebecca J Amos-Hirst, Rehana Bi, Collette M Spencer, Kevin P Morris, James Montgomerie, John Stickley, Adrian Crucean and 19 more

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in JTCVS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 29% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

29 authors at 7 institutions in 3 countries.

Nigel E DruryInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Carin van DoornDepartment of Congenital Cardiac Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Rebecca L WoolleyBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Rebecca J Amos-HirstBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Rehana BiDepartment of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
Collette M SpencerDepartment of Congenital Cardiac Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Kevin P MorrisDepartment of Paediatric Intensive Care, Birmingham Children's Hospital, Birmingham, United Kingdom.
James MontgomerieDepartment of Paediatric Cardiac Anesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom.
John StickleyDepartment of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
Adrian CruceanDepartment of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
Alicia GillBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Matt HillBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Ralf J M WeberPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Lukas NajdekrPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Andris JankevicsPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Andrew D SouthamPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Gavin R LloydPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Osama JaberDepartment of Congenital Cardiac Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Imre KassaiDepartment of Congenital Cardiac Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Giuseppe PelellaDepartment of Congenital Cardiac Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
Natasha E KhanDepartment of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
Phil BothaDepartment of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
David J BarronDivision of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Canada.
Melanie MadhaniInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Warwick B DunnPhenome Centre Birmingham, School of Biosciences, University of Birmingham, Birmingham, United Kingdom.
Natalie J IvesBirmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom.
Paulus KirchhofInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Timothy J JonesInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Bilateral Remote Ischemic Conditioning in Children Trial Investigators
Universität Hamburg · DEBirmingham Children's Hospital · GBUniversity of Birmingham · GBCancer Research UK Clinical Trials Unit · GBLeeds Teaching Hospitals NHS Trust · GBUniversity of Liverpool · GBUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: The study objective was to determine whether adequately delivered bilateral remote ischemic preconditioning is cardioprotective in young children undergoing surgery for 2 common congenital heart defects with or without cyanosis. Methods: We performed a prospective, double-blind, randomized controlled trial at 2 centers in the United Kingdom. Children aged 3 to 36 months undergoing tetralogy of Fallot repair or ventricular septal defect closure were randomized 1:1 to receive bilateral preconditioning or sham intervention. Participants were followed up until hospital discharge or 30 days. The primary outcome was area under the curve for high-sensitivity troponin-T in the first 24 hours after surgery, analyzed by intention-to-treat. Right atrial biopsies were obtained in selected participants. Results: Between October 2016 and December 2020, 120 eligible children were randomized to receive bilateral preconditioning (n = 60) or sham intervention (n = 60). The primary outcome, area under the curve for high-sensitivity troponin-T, was higher in the preconditioning group (mean: 70.0 ± 50.9 μg/L/h, n = 56) than in controls (mean: 55.6 ± 30.1 μg/L/h, n = 58) (mean difference, 13.2 μg/L/h; 95% CI, 0.5-25.8; Conclusions: Bilateral remote ischemic preconditioning does not attenuate myocardial injury in children undergoing surgical repair for congenital heart defects, and there was evidence of potential harm in unstented tetralogy of Fallot. The routine use of remote ischemic preconditioning cannot be recommended for myocardial protection during pediatric cardiac surgery.

Indexed as

clinical trialcyanosismyocardial protectionpediatric cardiac surgeryremote ischemic preconditioningtetralogy of Fallot

Identifiers

PMID38690427
PMCPMC11056492
OpenAlexW4392467772

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.