Evidence mapPaperPMID 29092664Full record

SynthesisWorld journal for pediatric & congenital heart surgery2018

The Perspective of the Intensivist on Inotropes and Postoperative Care Following Pediatric Heart Surgery: An International Survey and Systematic Review of the Literature.

Peter P Roeleveld, J C A de Klerk

Open access · bronzeAbstract readSystematic Review
In one paragraph

Synthesis in World journal for pediatric & congenital heart surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
4.7field-weighted citation impact, top 5% of its field
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

16 citing papers in PubMed, 49 citations in OpenAlex.

  1. Trial
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  6. Observational
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  15. Vasopressin Is No Inotrope.World journal for pediatric & congenital heart surgery · 2018
    Article
  16. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Peter P Roeleveld1 Department of Pediatric Intensive Care, Leiden University Medical center, Leiden, The Netherlands.ORCID 0000-0001-5491-9408
J C A de Klerk2 Department of Neonatal Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Erasmus MC - Sophia Children’s Hospital · NLLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery.

methodsWe developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey. We also performed a systematic review of the literature.

resultsNinety-eight people (50%) responded, representing 62 international centers. Milrinone is routinely used perioperatively by 90 respondents (97%). Adrenaline/epinephrine is routinely used by 43%, dopamine by 36%, dobutamine by 11%, and levosimendan by 6%. Steroids are used routinely by 54% before initiating cardiopulmonary bypass. Vasopressin is used by 44% of respondents. The development of LCOS is monitored with lactate in 99% of respondents, physical examination (98%), intermittent mixed venous saturation (76%), continuous mixed venous saturation (13%), echocardiography (53%), core-peripheral temperature gap (29%), near-infrared spectrometry (25%), and 4% use cardiac output monitors (PiCCO, USCOM). To improve cardiac output, 42% add/increase milrinone, 37% add adrenaline, and 15% add dopamine. Rescue therapy is titrated individually, based on the patients' pathophysiology. A systematic review of the literature failed to show compelling evidence with regard to the benefit of inotropes.

conclusionsDespite the lack of sufficient evidence, milrinone is used by the vast majority of caregivers following congenital heart surgery.

Indexed as

Postoperative CareAnimalsCardiac OutputCardiac Output, LowCardiac Surgical ProceduresCardiotonic AgentsEuropeHealth Care SurveysHeart Defects, CongenitalHumansPediatricsUnited StatesCardiotonic Agentschildinotropeslow cardiac output syndromepediatric and congenital cardiac surgerypreventionsurvey

Identifiers

PMID29092664
PMCPMC5764149
OpenAlexW2766975863

What Socratic holds

Textmetadata
LicenceCC BY-NC
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 Socratic graph.