Asante-Siaw Julius, Tyrrell James, Hoschtitzky Andreas, Dunning Joel
Department of Cardiothoracic Surgery, North Staffordshire Royal Infirmary, Stoke on Trent, UK.
Interact Cardiovasc Thorac Surg. 2006 Apr;5(2):128-34. doi: 10.1510/icvts.2005.126961. Epub 2006 Jan 12.
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether a centrifugal pump is better than a roller pump in patients undergoing cardiac surgery. Altogether 93 papers were identified using the below mentioned search, of which 15 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group, relevant outcomes and weaknesses were tabulated. We conclude that there is no evidence for the benefit of a centrifugal pump over a roller pump in elective coronary artery bypass grafting in respect of blood loss, clinical outcomes or neurological problems. The two largest studies, a large RCT of 1000 patients and a cohort study of 4000 patients, both demonstrated a halving in the incidence of neurological events with numbers needed to treat of 37 and 91. However, the remaining much smaller RCTs and cohort studies that we assessed failed to show significant differences in either clinical or biochemical markers.
根据结构化方案撰写了一篇心脏外科的最佳证据主题文章。所探讨的问题是，在接受心脏手术的患者中，离心泵是否优于滚压泵。通过下述检索共识别出93篇论文，其中15篇论文提供了回答该临床问题的最佳证据。将作者、期刊、出版日期和国家、患者群体、相关结果及不足之处制成表格。我们得出结论，在择期冠状动脉搭桥手术中，就失血、临床结果或神经问题而言，没有证据表明离心泵优于滚压泵。两项规模最大的研究，一项纳入1000例患者的大型随机对照试验和一项纳入4000例患者的队列研究，均显示神经事件发生率减半，治疗所需人数分别为37和91。然而，我们评估的其余规模小得多的随机对照试验和队列研究未能在临床或生化指标上显示出显著差异。
