Evidence map›Paper›PMID 39855339›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2025

The circulatory arrest recovery ammonia problem (CARAP) hypothesis: A proton magnetic resonance spectroscopy (

Daniel Spielman, Meng Gu, Hunter Liu, Shie-Chau Liu, Ralph Hurd, Kirk Riemer, Kenichi Okamura, Masafumi Shibata, Paul Shuttleworth, Zachary Kleiman and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. PreclinicalMagnetic resonance in medicine · 2026
    Article
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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

13 authors.

Daniel SpielmanDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif. Electronic address: spielman@stanford.edu.
Meng GuDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Hunter LiuDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Shie-Chau LiuDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Ralph HurdDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Kirk RiemerDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
Kenichi OkamuraDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif; Department of Pediatric Cardiothoracic Surgery, MUSC Shawn Jenkins Children's Hosptital, Charleston, SC.
Masafumi ShibataDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
Paul ShuttleworthDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
Zachary KleimanDepartment of Anesthesia, Stanford University School of Medicine, Stanford, Calif.
Karla EppersonDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Kevin EppersonDepartment of Radiology, Stanford University School of Medicine, Stanford, Calif.
Frank HanleyDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.

Funding

Neurometabolic Outcomes of Different Cardiopulmonary Bypass StrategiesR01HL152757 · NHLBI · STANFORD UNIVERSITY · PI HANLEY, FRANK, SPIELMAN, DANIEL M · 2021 to 2024
$2.9M
NHLBI NIH HHS R01 HL152757
6 · The paper itself

Abstract

objectiveCongenital heart disease affects 1% of US births, with many babies requiring major cardiothoracic surgery under cardiopulmonary bypass (CPB), exposing the more critical patients to neurodevelopmental impairment. Optimal surgical parameters to minimize neuronal injury are unknown. We used proton magnetic resonance spectroscopy (

methodsTwo-week old piglets (N = 17) were put on a CPB pump and placed in a 3-T magnetic resonance imaging to study brain metabolism during CPB. Dynamic single-voxel

resultsAll animals showed a transitory temperature-dependent increase in blood ammonia (P < .001) immediately after restart of whole-body perfusion. In contrast, metabolic processing of brain ammonia, as detected by an increased

conclusionsSerial

Indexed as

AmmoniaBrainCardiopulmonary BypassHeart Arrest, InducedHyperammonemiaProton Magnetic Resonance SpectroscopyAnimalsAnimals, NewbornCerebrovascular CirculationDisease Models, AnimalSus scrofaSwineTime FactorsAmmoniaammoniaantegrade cerebral perfusionbrain metabolismcardiopulmonary bypassdeep hyperthermic circulatory arrestmagnetic resonance spectroscopyneonatal

Identifiers

PMID39855339
PMCPMC12280089

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.