Kot, Thompson Ka Ming 
ORCID: 0000-0003-4821-9813, Chan, Jeffrey Shi Kai ORCID: 0000-0003-0231-2393, Froghi, Saied ORCID: 0000-0001-5152-6297, Lau, Dawnie Ho Hei, Morgan, Kara, Magni, Francesco ORCID: 0000-0003-4504-2434 and Harky, Amer ORCID: 0000-0001-5507-5841
(2021)
Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysis.
JTCVS open, 6 (Eur J ).
pp. 161-190.
|
PDF
Warm versus cold cardioplegia in cardiac surgery A meta-analysis with trial sequential analysis.pdf - Published version Download (2MB) | Preview |
Abstract
<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>Concerning safety outcomes, current evidence suggests that the choice between warm and cold cardioplegia remains in the surgeon's preference.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | AF, atrial fibrillation, AKI, acute kidney injury, CABG, coronary artery bypass graft, CI, confidence interval, IABP, intra-aortic balloon pump, ICU, intensive care unit, LCOS, low cardiac output syndrome, LOS, length of stay, MI, myocardial infarction, NOS, Newcastle–Ottawa Quality Assessment Scale, PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, RCT, randomized controlled trial, RR, risk ratio, TSA, trial sequential analysis, WMD, weighted mean difference, cardiac surgeries, cold cardioplegia, meta-analysis, trial sequential analysis, warm cardioplegia |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 07 Mar 2023 13:52 |
| Last Modified: | 15 Mar 2024 14:37 |
| DOI: | 10.1016/j.xjon.2021.03.011 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3168819 |
Dimensions
Dimensions
