Evidence map›Paper›PMID 36914049›Full record

Trial reportThe Journal of pediatrics2023

Hemodynamic Changes with Umbilical Cord Milking in Nonvigorous Newborns: A Randomized Cluster Cross-over Trial.

Anup Katheria, Judith Mercer, Deb Poeltler, Ana Morales, Nohemi Torres, Satyan Lakshminrusimha, Yogen Singh

Open access · greenAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in The Journal of pediatrics, 2023. 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
0.9field-weighted citation impact, top 26% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. 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

7 authors at 4 institutions in 1 country.

Anup KatheriaDivision of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA. Electronic address: akatheria@gmail.com.
Judith MercerDivision of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA; Department of Obstetrics, University of Rhode Island, Kingston, RI.
Deb PoeltlerDivision of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA.
Ana MoralesDivision of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA.
Nohemi TorresDivision of Neonatology, Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA.
Satyan LakshminrusimhaDepartment of Pediatrics, University of California Davis Children's Hospital, Sacramento, CA.
Yogen SinghDepartment of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA.
Sharp Mary Birch Hospital for Women & Newborns · USLoma Linda University · USUC Davis Children's Hospital · USUniversity of Rhode Island · US

Funding

Umbilical Cord Milking in Non Vigorous Infants (the MINVI Trial)R01HD096023 · NICHD · SHARP MEMORIAL HOSPITAL · PI KATHERIA, ANUP C · 2018 to 2022
$3.1M
A Cluster Randomized Clinical Trial of Umbilical Cord Milking to Improve Short and Long-term Outcomes in Neonates Who are Non-Vigorous at BirthR01HD102967 · NICHD · NEMOURS CHILDREN'S HOSPITAL, DELAWARE · PI AGHAI, ZUBAIR H, DHADED, SANGAPPA M · 2021 to 2024
$2.3M
NICHD NIH HHS R01 HD096023NICHD NIH HHS R01 HD102967
6 · The paper itself

Abstract

objectiveTo assess the hemodynamic safety and efficacy of umbilical cord milking (UCM) compared with early cord clamping (ECC) in nonvigorous newborn infants enrolled in a large multicenter randomized cluster-crossover trial. STUDY

designTwo hundred twenty-seven nonvigorous term or near-term infants who were enrolled in the parent UCM vs ECC trial consented for this substudy. An echocardiogram was performed at 12 ± 6 hours of age by ultrasound technicians blinded to randomization. The primary outcome was left ventricular output (LVO). Prespecified secondary outcomes included measured superior vena cava (SVC) flow, right ventricular output (RVO), peak systolic strain, and peak systolic velocity by tissue Doppler examination of the RV lateral wall and the interventricular septum.

resultsNonvigorous infants receiving UCM had increased hemodynamic echocardiographic parameters as measured by higher LVO (225 ± 64 vs 187 ± 52 mL/kg/min; P < .001), RVO (284 ± 88 vs 222 ± 96 mL/kg/min; P < .001), and SVC flow (100 ± 36 vs 86 ± 40 mL/kg/min; P < .001) compared with the ECC group. Peak systolic strain was lower (-17 ± 3 vs -22 ± 3%; P < .001), but there was no difference in peak tissue Doppler flow (0.06 m/s [IQR, 0.05-0.07 m/s] vs 0.06 m/s [IQR, 0.05-0.08 m/s]).

conclusionsUCM increased cardiac output (as measured by LVO) compared with ECC in nonvigorous newborns. Overall increases in measures of cerebral and pulmonary blood flow (as measured by SVC and RVO flow, respectively) may explain improved outcomes associated with UCM (less cardiorespiratory support at birth and fewer cases of moderate-to-severe hypoxic ischemic encephalopathy) among nonvigorous newborn infants.

Indexed as

Infant, PrematureUmbilical Cord ClampingConstrictionCross-Over StudiesFemaleHemodynamicsHumansInfantInfant, NewbornPregnancyUmbilical CordVena Cava, Superiordelayed cord clampingearly cord clampinghypoxic ischemic encephalopathy

Identifiers

PMID36914049
PMCPMC10293099
OpenAlexW4323922563

What Socratic holds

Textmetadata
LicenceTDM
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.