Effect of dexmedetomidine on prognosis of patients after cardiac surgery with cardiopulmonary bypass: A systematic review and meta-analysis
10.7507/1007-4848.201704027
- VernacularTitle:右美托咪定对体外循环心脏手术后患者围术期预后影响的系统评价与 Meta 分析
- Author:
WANG Xiaowen
1
,
2
;
ZHANG Cheng
1
,
2
;
LI Linjun
1
,
2
;
ZHOU Ruiqin
1
,
2
;
HUANG Chun
3
;
JIANG Yingjiu
3
;
WU Qingchen
3
Author Information
1. 1. Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
2. 2. Department of Cardiothoracic Surgery ICU, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
3. Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
cardiac surgery;
meta-analysis;
randomized controlled trial
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(4):325-332
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of dexmedetomidine in perioperative management of on-pump cardiac surgery. Methods Randomized controlled trials (RCTs) were identified through a systematic literature search of PubMed, EBSCO, Web of Science, Cochrane Library, CBM, CNKI, Wanfang Database (up to December 2016). RevMan 5.3 software was used for meta-analysis. Results Sixteen studies with 1 432 patients were included. Dexmedetomidine significantly decreased the risk of postoperative delirium (RR=0.28, 95% CI 0.18 to 0.44, P<0.000 01) and postoperative atrial fibrillation (RR=0.65, 95% CI 0.44 to 0.98, P=0.04) compared with the controls. The duration of intubation (RR=–1.96, 95% CI –2.07 to –1.86, P<0.000 01), length of ICU stay (RR=–0.49, 95% CI –0.74, –0.24, P=0.000 1) and hospital stay (RR=–1.24, 95% CI –2.26 to –0.22, P=0.02) in the dexmedetomidine group were significantly shorter than those of the control group. In addition, dexmedetomidine was shown to improve the score of the the Montreal Cognitive Assessment (RR=0.88, 95% CI 0.42 to 1.35, P=0.000 2) compared to the control group. Conclusion Dexmedetomidine can reduce the complications after cardiac surgery, which is safe and effective. However, more studies with good methodologic quality and large samples are still needed to make further assessment.
