Evidence map›Paper›PMID 39833714›Full record

ArticleBMC cardiovascular disorders2025

Impact of mild hypothermic circulatory arrest on surgical outcomes in acute type a aortic dissection patients: a single-centre study.

Zhenxiong Li, Hao Tang, Chao Deng, Kangjun Shen, Jingyu Li, Song Tian, WenYao Zhan, Ling Tan

Abstract readComparative Study
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

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

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. 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.

Zhenxiong Li *Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Hao TangDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Chao DengDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Kangjun ShenDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Jingyu LiDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Song TianDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
WenYao ZhanDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Ling TanDepartment of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, China. dr.tanling@csu.edu.cn.

Funding

2023 Annual Research Projects of Hunan Province Health Commission C202304027218the Key Research and Development Program of Hunan Province No. 2019SK2022
6 · The paper itself

Abstract

backgroundAs hypothermic circulatory arrest (HCA) is being more frequently induced in patients undergoing aortic arch surgery, its safety at different degrees has become a crucial area of study. The aim of this study was to assess the surgical outcomes of mild hypothermic circulatory arrest (MI-HCA) during aortic arch surgery.

methodsAcute type A aortic dissection (ATAAD) patients who underwent total arch replacement (TAR) and frozen elephant trunk (FET) surgery between January 2014 and December 2023 were enrolled in this study. The patients were divided into two groups according to the minimum nasopharyngeal temperature: the moderate hypothermic circulatory arrest (MHCA) group (20-28 °C) and the MI-HCA group (> 28 °C). The inverse probability of treatment weighting (IPTW) was used to balance differences in the baseline characteristics. Perioperative variables were analysed via pairwise comparisons, multivariable logistic regression, and subgroup forest plots to assess the impact of MI-HCA on surgical outcomes.

resultsA total of 447 patients were included in this study, and the mean minimum nasopharyngeal temperature was 24.80 (23.98, 27.30) °C in the MHCA group and 30.10 (29.80, 30.70) °C in the MI-HCA group. The incidence of acute kidney injury (AKI) in the MI-HCA group was lower than that in the MHCA group (52% vs. 78%, p < 0.01). In the multivariable logistic regression analysis, MI-HCA was identified as an independent protective factor for AKI (OR = 0.354, 95% CI 0.177-0.689; p = 0.003). Additionally, compared with MHCA, MI-HCA was not associated with an increased incidence of stroke, spinal cord injury, or in-hospital mortality. After IPTW, the preoperative and intraoperative data of the patients were balanced, and the incidence of AKI in the MI-HCA group was still lower than that in the MHCA group (83.26% vs. 53.61%, p = 0.004). The subgroup forest plot also demonstrated that MI-HCA was a protective factor for postoperative AKI.

conclusionsThe surgical outcomes of MI-HCA in ATAAD patients were satisfactory. Compared with MHCA, MI-HCA provided sufficient protection for distal organs, the brain, and the spinal cord, with a significantly lower incidence of AKI. These results indicate that MI-HCA could be a better approach for ATAAD surgery.

Indexed as

Aorta, ThoracicAortic Aneurysm, ThoracicAortic DissectionBlood Vessel Prosthesis ImplantationHeart Arrest, InducedHypothermia, InducedAcute DiseaseAdultAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk AssessmentAcute kidney injuryAcute type a aortic dissectionInverse probability of treatment weightingMild hypothermic circulatory arrestSubgroup forest plotSurgical outcomes

Identifiers

PMID39833714
PMCPMC11748564

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.