Jinming Zeng1, Wenwu He2, Zhanli Qu3, Yanyan Tang3, Qiuxi Zhou4, Bingdong Zhang5. 1. Department of Anesthesia of Cardiovascular Institute, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi. Electronic address: zbdong2007@126.com. 2. Department of Cardiothoracic Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan. 3. Department of Neurology. 4. Department of Cardiology, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China. 5. Department of Anesthesia of Cardiovascular Institute, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi.
Abstract
OBJECTIVE: The purpose of this article was to systematically review randomized controlled trials in which cold blood cardioplegia was compared with cold crystalloid cardioplegia for cardiac surgery. DESIGN: Correlation studies were searched independently in the EMBASE, MEDLINE and Cochrane library databases. The primary endpoints of interest were spontaneous sinus rhythm (SSR) after declamping, perioperative myocardial infarction (MI) and mortality (within 30 days). SETTING: A hospital. PARTICIPANTS: Randomized controlled trials. INTERVENTION: A meta-analysis of 12 studies. MEASUREMENTS AND MAIN RESULTS: The 12 included trials recruited a total of 2866 participants; 1357 patients received cold crystalloid cardioplegia, and 1509 patients received cold blood cardioplegia. The pooled analysis showed no significant difference favoring either cold crystalloid cardioplegia or cold blood cardioplegia in terms of spontaneous sinus rhythm (SSR) after declamping (789/1028 [76.75%] v 773/1025 [75.41%], relative risk (RR) = 0.92 [0.76, 1.13], p = 0.43 with 6 studies included), mortality (within 30 days) (20/1335 [1.50%] v 24/1469 [1.63%], relative risk (RR) = 1.09 [0.62, 1.91], p = 0.77 with 11 studies included), atrial fibrillation (AF) (329/1043 [31.54%] v 365/1040 [35.10%], RR =0.90 [0.80, 1.01], p = 0.08 with 6 studies included) or stroke (45/1114 [4.04%] v 20/1240 [1.61%], RR = 2.18 [0.69, 6.93], p = 0.19 with 4 studies included). The aggregate data showed that the incidence of perioperative myocardial infarction was lower in patients who received cold blood cardioplegia (CB) (32/1310 [2.44%] v 17/1434 [1.19%], RR = 2.30 [1.33, 3.98], p = 0.003 with 11 studies included). CONCLUSIONS: Cold blood cardioplegia reduced perioperative myocardial infarction when compared with cold crystalloid cardioplegia. No differences in the overall incidence rates of spontaneous sinus rhythm, mortality (within 30 days), atrial fibrillation or stroke were observed.
OBJECTIVE: The purpose of this article was to systematically review randomized controlled trials in which cold blood cardioplegia was compared with cold crystalloid cardioplegia for cardiac surgery. DESIGN: Correlation studies were searched independently in the EMBASE, MEDLINE and Cochrane library databases. The primary endpoints of interest were spontaneous sinus rhythm (SSR) after declamping, perioperative myocardial infarction (MI) and mortality (within 30 days). SETTING: A hospital. PARTICIPANTS: Randomized controlled trials. INTERVENTION: A meta-analysis of 12 studies. MEASUREMENTS AND MAIN RESULTS: The 12 included trials recruited a total of 2866 participants; 1357 patients received cold crystalloid cardioplegia, and 1509 patients received cold blood cardioplegia. The pooled analysis showed no significant difference favoring either cold crystalloid cardioplegia or cold blood cardioplegia in terms of spontaneous sinus rhythm (SSR) after declamping (789/1028 [76.75%] v 773/1025 [75.41%], relative risk (RR) = 0.92 [0.76, 1.13], p = 0.43 with 6 studies included), mortality (within 30 days) (20/1335 [1.50%] v 24/1469 [1.63%], relative risk (RR) = 1.09 [0.62, 1.91], p = 0.77 with 11 studies included), atrial fibrillation (AF) (329/1043 [31.54%] v 365/1040 [35.10%], RR =0.90 [0.80, 1.01], p = 0.08 with 6 studies included) or stroke (45/1114 [4.04%] v 20/1240 [1.61%], RR = 2.18 [0.69, 6.93], p = 0.19 with 4 studies included). The aggregate data showed that the incidence of perioperative myocardial infarction was lower in patients who received cold blood cardioplegia (CB) (32/1310 [2.44%] v 17/1434 [1.19%], RR = 2.30 [1.33, 3.98], p = 0.003 with 11 studies included). CONCLUSIONS: Cold blood cardioplegia reduced perioperative myocardial infarction when compared with cold crystalloid cardioplegia. No differences in the overall incidence rates of spontaneous sinus rhythm, mortality (within 30 days), atrial fibrillation or stroke were observed.
Authors: Claudiu Ghiragosian; Marius Harpa; Alexandra Stoica; Flămînd Oltean Sânziana; Radu Bălău; Hussam Al Hussein; Ghiragosian-Rusu Simina Elena; Radu Mircea Neagoe; Horațiu Suciu Journal: J Cardiovasc Dev Dis Date: 2022-06-02
Authors: Paolo Nardi; Calogera Pisano; Fabio Bertoldo; Sara R Vacirca; Guglielmo Saitto; Antonino Costantino; Emanuele Bovio; Antonio Pellegrino; Giovanni Ruvolo Journal: Cell Death Discov Date: 2018-02-14