Evidence map›Paper›PMID 39344668›Full record

Trial reportJournal of the American Heart Association2024

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial.

Chris A Rogers, Graziella Mazza, Rachel Maishman, Russell Thirard, Jonathan Evans, Samantha de Jesus, Chloe Beard, Gianni Angelini, Ann Millar, Nabil Jarad and 4 more

Abstract readRandomized Controlled TrialClinical Trial, Phase II
In one paragraph

Trial report in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. National Heart Center Perfusion Guidelines.Saudi medical journal · 2026
    Guideline
  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

14 authors.

Chris A RogersBristol Trials Centre, Bristol Medical School University of Bristol UK.ORCID 0000-0002-9624-2615
Graziella MazzaBristol Trials Centre, Bristol Medical School University of Bristol UK.ORCID 0000-0002-6986-1699
Rachel MaishmanBristol Trials Centre, Bristol Medical School University of Bristol UK.ORCID 0000-0002-5052-5951
Russell ThirardBristol Trials Centre, Bristol Medical School University of Bristol UK.
Jonathan EvansBristol Trials Centre, Bristol Medical School University of Bristol UK.
Samantha de JesusBristol Trials Centre, Bristol Medical School University of Bristol UK.
Chloe BeardBristol Trials Centre, Bristol Medical School University of Bristol UK.ORCID 0000-0001-9802-4171
Gianni AngeliniFaculty of Life and Health Sciences, Bristol Heart Institute University of Bristol UK.ORCID 0000-0002-1753-3730
Ann MillarRespiratory Medicine Southmead Hospital Bristol UK.
Nabil JaradDepartment of Respiratory Medicine University Hospital Bristol and Weston NHS Foundation Trust Bristol UK.
Sally TomkinsFaculty of Life and Health Sciences, Bristol Heart Institute University of Bristol UK.
James HillierFaculty of Life and Health Sciences, Bristol Heart Institute University of Bristol UK.ORCID 0000-0001-9591-6510
M-Saadeh SuleimanFaculty of Life and Health Sciences, Bristol Heart Institute University of Bristol UK.ORCID 0000-0001-6080-480X
Raimondo AscioneFaculty of Life and Health Sciences, Bristol Heart Institute University of Bristol UK.ORCID 0000-0001-8045-5619

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac surgery with cardiopulmonary bypass (CPB) triggers pulmonary injury. In this trial we assessed the feasibility, safety, and efficacy of low frequency ventilation (LFV) during CPB in patients undergoing valvular surgery. METHODS AND

resultsPatients with severe mitral or aortic valve disease were randomized to either LFV or usual care. Primary outcomes included release of generic inflammatory and vascular biomarkers and the lung-specific biomarker sRAGE (soluble receptor for advance glycation end products) up to 24 hours postsurgery. Secondary outcomes included pulmonary function tests and 6-minute walking test up to 8 weeks postdischarge. Sixty-three patients were randomized (33 LFV versus 30 usual care). Mean age was 66.8 years and 30% were female. LFV was associated with changes of sRAGE (soluble receptor for advance glycation end products) levels (geometric mean ratio, 3.05; [95% CI, 1.13-8.24] 10 minutes post CPB, and 1.07 [95% CI, 0.64-1.79], 0.84 [95% CI, 0.55-1.27], 0.67 [95% CI, 0.42-1.07], and 0.62 [95% CI, 0.45-0.85] at 2, 6, 12, and 24 hours post CPB respectively). No changes were observed for any of the generic biomarkers. Respiratory index soon after surgery (mean difference, -0.61 [95% CI, -1.24 to 0.015] 10 minutes post end of CPB), forced expiratory volume after 1 second/forced vital capacity ratio (0.050 [95% CI, 0.007-0.093] at 6 to 8 weeks pos-surgery), Forced vital capacity alone (95% CI, -0.191 L [-0.394 to 0.012]) and 6-minute walking test score at discharge (63.2 m [95% CI, 12.9-113.6]) were better preserved in the LFV group. No other differences were noted.

conclusionsThe use of LFV during CPB in patients undergoing valvular surgery was feasible and safe and was associated with changes in sRAGE levels along with better preserved lung function and walking performance. These observations warrant further investigation in larger future studies. REGISTRATION: URL: https://www.isrctn.com; Unique Identifier: ISRCTN75795633.

Indexed as

BiomarkersCardiopulmonary BypassHeart Valve DiseasesAgedAortic ValveCardiac Surgical ProceduresFeasibility StudiesFemaleHeart Valve Prosthesis ImplantationHumansLungMaleMiddle AgedMitral ValvePostoperative ComplicationsReceptor for Advanced Glycation End ProductsBiomarkersReceptor for Advanced Glycation End Productscardiopulmonary bypasslow frequency ventilationlung protectionpulmonary function testssRAGEvalvular surgery

Identifiers

PMID39344668
PMCPMC11681471

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.