Evidence map›Paper›PMID 39468558›Full record

ArticleBMC pulmonary medicine2024

Management and outcomes in pulmonary arterial hypertension patients with sepsis.

Spencer Flynn, Haidee Chen, Russell Kerbel, Summer Gupta, Sonia Jasuja, Rajan Saggar, Richard Channick, Alexander Sherman

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pulmonary medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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

2 citing papers in PubMed.

  1. Review
  2. Evaluation and Management of Sepsis in Pulmonary Hypertension.Journal of intensive care medicine · 2025
    Review
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.

Spencer FlynnDavid Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Haidee ChenDavid Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Russell KerbelDepartment of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Summer GuptaDepartment of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Sonia JasujaDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 365, Los Angeles, CA, 90095, USA.
Rajan SaggarDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 365, Los Angeles, CA, 90095, USA.
Richard ChannickDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 365, Los Angeles, CA, 90095, USA.
Alexander ShermanDivision of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 365, Los Angeles, CA, 90095, USA. alexandershermanmd@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSepsis is a common cause of death in patients with pulmonary arterial hypertension (PAH). Treatment requires careful fluid management and hemodynamic support. This study compares patients with or without PAH presenting with sepsis with a focus on initial fluid resuscitation.

methodsThis retrospective analysis compared adults with and without PAH admitted for sepsis at two academic hospitals between 2013 and 2022. Prior PAH diagnosis was verified by review of right heart catheterization data and sepsis present on admission was verified by chart review. Demographics, vital signs, laboratory values, imaging results, treatment approaches, and all-cause mortality data were obtained. Controls were propensity score weighted by age, sex, and Charlson Comorbidity index. Logistic regression models controlling for age and Charlson comorbidity indices were used to examine factors associated with survival.

resultsThirty patients admitted for sepsis with pre-existing PAH were compared to 96 matched controls. Controls received significantly more fluids at 24 h compared to PAH patients (median 0 mL v. 1216 mL, p < 0.001), while PAH patients were more likely to receive vasoactive medications (23.3% vs. 8.3%, p = 0.037). At 30 days, 7 PAH patients (23.3%) and 13 control patients (13.5%) had died (p = 0.376). PAH patients that received more fluids had decreased mortality (OR 0.31, 95% CI 0.11-0.92, p = 0.03) and patients who received fluids had shorter mean time to antibiotics (2.3 h v. 6.5 h, p = 0.04), although decreased time to antibiotics was not associated with mortality. Patients who received no fluids more often had previously identified right ventricular systolic dysfunction (62.5% v. 28.6%, p = 0.136).

conclusionPatients with PAH and sepsis have high mortality and receive different treatments than controls, with more reliance on vasopressors and less on fluid resuscitation. PAH patients who received less fluids had higher mortality and those who received no fluids had a longer time to receiving antibiotics, indicating a potential delay in recognizing sepsis. Timely recognition of sepsis and dynamic decision-making around fluid resuscitation remains critical in this high-risk population.

Indexed as

Fluid TherapyPulmonary Arterial HypertensionSepsisAdultAgedCase-Control StudiesFemaleHumansLogistic ModelsMaleMiddle AgedPropensity ScoreRetrospective StudiesFluid resuscitationPulmonary arterial hypertensionSepsis

Identifiers

PMID39468558
PMCPMC11520816

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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.