Volatile anesthetics versus total intravenous anesthesia for cardiac surgery
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F19%3A00077793" target="_blank" >RIV/00023001:_____/19:00077793 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/19:10406747 RIV/00064165:_____/19:10406747
Result on the web
<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1816476" target="_blank" >https://www.nejm.org/doi/full/10.1056/NEJMoa1816476</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1056/NEJMoa1816476" target="_blank" >10.1056/NEJMoa1816476</a>
Alternative languages
Result language
angličtina
Original language name
Volatile anesthetics versus total intravenous anesthesia for cardiac surgery
Original language description
BACKGROUND Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year. RESULTS A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P=0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction. CONCLUSIONS Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30223 - Anaesthesiology
Result continuities
Project
—
Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
New England journal of medicine
ISSN
0028-4793
e-ISSN
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Volume of the periodical
380
Issue of the periodical within the volume
13
Country of publishing house
US - UNITED STATES
Number of pages
12
Pages from-to
1214-1225
UT code for WoS article
000463251600006
EID of the result in the Scopus database
2-s2.0-85063716640