Evidence map›Paper›PMID 37575193›Full record

ArticleiScience2023

Methemoglobin as a marker of acute anemic stress in cardiac surgery.

Nikhil Mistry, Gregory M T Hare, Nadine Shehata, Robert S Kramer, Hosam F Fawzy, Robert A Baker, Paula Carmona, Richard Saczkowski, Daniela Filipescu, Christella S Alphonsus and 12 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in iScience, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02042898 (An International, Multi-centre, Randomized Controlled Trial to Assess Transfusion Thresholds in Patients Undergoing Cardiac Surgery), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 46% 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.

NCT02042898 nacompletednot on this map

An International, Multi-centre, Randomized Controlled Trial to Assess Transfusion Thresholds in Patients Undergoing Cardiac Surgery

TypeinterventionalSponsorUnity Health TorontoRan2014 to 2017Enrolled5,028ConditionsDisorder, Heart, Functional, Postoperative, Cardiac SurgeryArmsRestrictive Transfusion Strategy, Liberal transfusion strategy
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

22 authors at 17 institutions in 8 countries.

Nikhil MistryInstitute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
Gregory M T HareDepartment of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Nadine ShehataDivision of Hematology, Sinai Health System, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Robert S KramerMaine Medical Center Cardiovascular Institute, Portland, ME, USA.
Hosam F FawzyDepartment of Cardiothoracic Surgery, Faculty of Medicine, University of Tanta, Tanta, Egypt.
Robert A BakerCardiac Surgery Research and Perfusion, Flinders University and Flinders Medical Centre, Adelaide, SA, Australia.
Paula CarmonaCardiovascular-Anesthesia and Intensive Care. University Hospital La Fe, Valencia, Spain.
Richard SaczkowskiDepartment of Cardiac Sciences, Perfusion Services, Kelowna General Hospital, Kelowna, BC, Canada.
Daniela FilipescuUniversity of Medicine and Pharmacy Carol Davila, Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.C. Iliescu", Bucharest, Romania.
Christella S AlphonsusDepartment of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Antoine RochonMontreal Heart Institute, Montreal, QC, Canada.
Alexander J GregoryDepartment of Anesthesiology, Perioperative and Pain Medicine and Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Boris KhanykinCardiothoracic Anesthesiology Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Jonathan D LeffMontefiore-Einstein Center for Heart and Vascular Care, New York City, NY, USA.
Eva MateoHospital General Universitario de València, València, Spain.
Dimos KarangelisDepartment of Cardiothoracic Surgery, Democritus University of Thrace, Alexandroupolis, Greece.
Juan C TellezMarly Clinic, Bogotá, Cundinamarca, Colombia.
Tarit SahaDepartment of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Kingston, ON, Canada.
Dennis T KoSchulich Heart Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Duminda N WijeysunderaDepartment of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
Subodh VermaLi Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
C David MazerInstitute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
University of Toronto · CAUnity Health TorontoAlbert Einstein College of Medicine · USCopenhagen University Hospital · DKDemocritus University of Thrace · GRFlinders Medical Centre · AUHospital General Universitario De Valencia · ESHospital Universitari i Politècnic La Fe · ESKelowna General Hospital · CAKingston General Hospital · CALibin Cardiovascular Institute of Alberta · CAMaine Medical Center · USMontreal Heart Institute · CASt. Michael's Hospital · CASunnybrook Health Science Centre · CATanta University · EGUniversity of Cape Town · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Biological evidence supports plasma methemoglobin as a biomarker for anemia-induced tissue hypoxia. In this translational planned substudy of the multinational randomized controlled transfusion thresholds in cardiac surgery (TRICS-III) trial, which included adults undergoing cardiac surgery requiring cardiopulmonary bypass with a moderate-to-high risk of death, we investigated the relationship between perioperative hemoglobin concentration (Hb) and methemoglobin; and evaluated its association with postoperative outcomes. The primary endpoint was a composite of death, myocardial infarction, stroke, and severe acute kidney injury at 28 days. We observe weak non-linear associations between decreasing Hb and increasing methemoglobin, which were strongest in magnitude at the post-surgical time point. Increased levels of post-surgical methemoglobin were associated with a trend toward an elevated risk for stroke and exploratory neurological outcomes. Our generalizable study demonstrates post-surgical methemoglobin may be a marker of anemia-induced organ injury/dysfunction, and may have utility for guiding personalized approaches to anemia management. Clinicaltrials.gov registration NCT02042898.

Indexed as

Cardiovascular medicineHealth sciencesPublic healthSurgery

Identifiers

PMID37575193
PMCPMC10415918
OpenAlexW4384937354

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.