Evidence map›Paper›PMID 39077704›Full record

ArticleReviews in cardiovascular medicine2022

Comparative Effectiveness of Combined IgM-Enriched Immunoglobulin and Extracorporeal Blood Purification Plus Standard Care Versus Standard Care for Sepsis and Septic Shock after Cardiac Surgery.

Gianluca Paternoster, Silvia De Rosa, Pietro Bertini, Pasquale Innelli, Rosaria Vignale, Vincenzo Francesco Tripodi, Giuseppe Buscaglia, Mariacristina Vadalà, Michele Rossi, Antonio Arena and 8 more

Abstract read
In one paragraph

Article in Reviews in cardiovascular medicine, 2022. 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
–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

3 citing papers in PubMed.

  1. Review
  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

18 authors.

Gianluca PaternosterCardiovascular Anesthesia and ICU, San Carlo Hospital, 85100 Potenza, Italy.
Silvia De RosaDepartment of Anesthesia and Intensive Care Unit, San Bortolo Hospital, 36100 Vicenza, Italy.
Pietro BertiniDepartment of Aaesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy.
Pasquale InnelliIntensive Cardiac Care Unit, San Carlo Hospital, 85100 Potenza, Italy.
Rosaria VignaleCardiovascular Anesthesia and ICU, San Carlo Hospital, 85100 Potenza, Italy.
Vincenzo Francesco TripodiCardioThoracoVascular Department, Heart Center, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", 89124 Reggio Calabria, Italy.
Giuseppe BuscagliaCaridiovascular Anesthesia and ICU, Ospedale san Martino, 16132 Genova, Italy.
Mariacristina VadalàCardioThoracoVascular Department, Heart Center, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", 89124 Reggio Calabria, Italy.
Michele RossiCardioThoracoVascular Department, Heart Center, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", 89124 Reggio Calabria, Italy.
Antonio ArenaCaridiovascular Anesthesia and ICU, Ospedale san Martino, 16132 Genova, Italy.
Andrea DemartiniCaridiovascular Anesthesia and ICU, Ospedale san Martino, 16132 Genova, Italy.
Giovanni TripepiInstitute of Clinical Physiology (IFC-CNR), Clinical Epidemiology, And Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, 89124 Reggio Calabria, Italy.
Domenico AbelardoInstitute of Clinical Physiology (IFC-CNR), Clinical Epidemiology, And Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, 89124 Reggio Calabria, Italy.
Giuseppe PittellaCardiovascular Anesthesia and ICU, San Carlo Hospital, 85100 Potenza, Italy.
Aldo Di FazioRegional Complex Intercompany Institute of Legal Medicine, San Carlo Hospital, 85100 Potenza, Italy.
Sabino ScollettaDepartment of Emergency and Organ Transplant, University of Siena, 53100 Siena, Italy.
Fabio GuarracinoDepartment of Aaesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy.
Blanca Martinez Lopez de ArroyabeCardiothoracic and Vascular Anesthesia and Intensive Care University Hospital, 37126 Verona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The combination of surgery, bacterial spread-out, and artificial cardiopulmonary bypass surfaces results in a release of key inflammatory mediators leading to an overshooting systemic hyper-inflammatory condition frequently associated with compromised hemodynamics and organ dysfunction. A promising approach could be extracorporeal blood purification therapies in combination with IgM enriched immunoglobulin. This approach might perform a balanced control of both hyper and hypo-inflammatory phases as an immune-modulating intervention. Methods: We performed a retrospective observational study of patients with proven infection after cardiac surgery between January 2020 and December 2021. Patients were divided into two groups: (1) the first group (Control Group) followed a standard care approach as recommended by the Surviving Sepsis Campaign Guidelines; The second group (Active Group) underwent extracorporeal blood purification therapy (EBPT) in combination with intravenous administration of IgM enriched immunoglobulin 5 mL/kg die for at least three consecutive days, in conjunction with the standard approach (SSC Guidelines). In addition, ventriculo-arterial (V/A) coupling, Interleukin 6 (IL-6), Endotoxin Activity Assay (EAA), Procalcitonin, White Blood Cells (WBC) counts, Sequential Organ Failure Assessment (SOFA) Score and Inotropic Score were assessed in both two groups at different time points. Results: Fifty-four patients were recruited; 25 were in the Control Group, while 29 participants were in the Active Group. SOFA score significantly improved from baseline [12 (9-16)] until at Conclusions: EBPT, in combination with IgM enriched immunoglobulin, was associated with a mitigated postoperative response of key cytokines with a significant decrease in IL-6, Procalcitonin, and EAA and was associated with improvement of clinical and metabolic parameters.

Indexed as

blood purification therapycardiac surgeryhyper-inflammationIgM-enriched immunoglobulinimmunosuppressionpentaglobinsepsis

Identifiers

PMID39077704
PMCPMC11262381

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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.