未经评估:这项荟萃分析旨在比较成年患者心脏手术中使用热停搏液和冷停搏液的临床结果,试验序贯分析(TSA)用于确定结果的结论性。
UNASSIGNED:在PubMed上进行了电子搜索,Medline,Scopus,EMBASE,和Cochrane库,以确定所有比较心脏手术中热停搏液和冷停搏液的研究。主要终点为住院或30天死亡率,心肌梗塞,低心输出量综合征,主动脉内球囊泵的使用,中风,和新的心房颤动。次要终点为急性肾损伤,住院时间,和重症监护病房的住院时间。对(1)自2010年Fan及其同事发表以来发表的研究进行了预先指定的亚组分析,(2)随机对照研究,(3)具有低偏倚风险的研究,(4)冠状动脉搭桥术,(5)冷血与冷晶体心脏停搏液的研究。进行TSA以确定结果的结论性,使用低偏倚风险研究中没有显著异质性的所有结局。
未经证实:术后死亡率无显著差异,心肌梗塞,低心输出量综合征,主动脉内球囊泵的使用,中风,新的心房颤动,热停搏液和冷停搏液之间的急性肾损伤。TSA得出结论,目前的证据足以排除这些结果的相对风险降低20%。
未经批准:关于安全结果,目前的证据表明,在热停搏液和冷停搏液之间的选择仍然是外科医生的偏好。
UNASSIGNED: This meta-analysis aimed to compare clinical outcomes of warm and cold cardioplegia in cardiac surgeries in adult patients, with
trial sequential analysis (TSA) used to determine the conclusiveness of the results.
UNASSIGNED: Electronic searches were performed on PubMed, Medline, Scopus, EMBASE, and Cochrane library to identify all studies that compared warm and cold cardioplegia in cardiac surgeries. Primary end points were in-hospital or 30-day mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, and new atrial fibrillation. Secondary end points were acute kidney injury, hospital length of stay, and intensive care unit length of stay. Prespecified subgroup analyses were performed for (1) studies published since publication of Fan and colleagues in 2010, (2) randomized controlled studies, (3) studies with low risk of bias, (4) coronary artery bypass graft surgeries, and (5) studies with cold blood versus those with cold crystalloid cardioplegia. TSA was performed to determine conclusiveness of the results, using on all outcomes without significant heterogeneity from studies of low risk of bias.
UNASSIGNED: No significant differences were found between post-operative rates of mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, new atrial fibrillation, and acute kidney injury between warm and cold cardioplegia. TSA concluded that current evidence was sufficient to rule out a 20% relative risk reduction in these outcomes.
UNASSIGNED: Concerning safety outcomes, current evidence suggests that the choice between warm and cold cardioplegia remains in the surgeon\'s preference.