Affiliation:
1. Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
2. Laboratory of Extracorporeal Life Support, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
Abstract
Objective: Although the application of del Nido cardioplegia solution (DNC) in adult cardiac surgery is accumulating, the feasibility and safety of this myocardial protection strategy in adults remains controversial. We aimed to update our previous meta-analysis to determine the myocardial protective effect of DNC versus conventional cardioplegia (CC) in adult cardiac surgery. Methods: A comprehensive literature search was performed using PubMed, EMBASE, the Cochrane Library, and International Clinical Trials Registry Platform databases through November 2020. Results: Thirty-seven observational studies and four randomized controlled trials (RCTs) including 21,779 patients were identified. The DNC group was associated with decreased postoperative cardiac enzymes [troponin T (cTnT) and creatine kinase-MB (CK-MB)] [standardized mean differences (SMD): −0.59, 95% confidence interval (CI): −0.99 to −0.19, p = 0.004], cardiopulmonary bypass (CPB) time (MD: −9.31, 95% CI: −13.10 to −5.51, p < 0.00001), aortic cross-clamp (ACC) time (MD: −7.20, 95% CI: −10.31 to −4.09, p < 0.00001), and cardioplegia volume (SMD: −1.95, 95% CI: −2.46 to −1.44, p < 0.00001). Intraoperative defibrillation requirement was less in the DNC group [relative risk (RR): 0.50, 95% CI: 0.33 to 0.75, p = 0.0007]. The pooled analysis revealed no significant difference in operative mortality among the patients assigned to DNC and those undergoing CC. Conclusion: In adult cardiac surgery, compared to CC, myocardial protection used with DNC yield similar or better short-term clinical outcomes. More high-quality trials and RCTs reflecting long-term follow-up morbidity and mortality are required in the future to confirm these findings.
Funder
the Science-Technology Foundation for Young Scientist of Gansu Province
lanzhou university
the Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital
special fund project of guiding scientific and technological innovation development of gansu province
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Safety Research,Radiology, Nuclear Medicine and imaging,General Medicine
Cited by
9 articles.
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