From the Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
ASAIO J. 2018 May/Jun;64(3):360-367. doi: 10.1097/MAT.0000000000000652.
Cardioplegia is an important strategy for myocardial protection during cardiac surgery. This meta-analysis was to compare the effects of del Nido and conventional cardioplegia in adult patients. Systematic searches were performed to identify studies using PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform. A total of nine studies were included. Cardiopulmonary bypass and cross-clamp time were significantly shorter in the del Nido than conventional cardioplegia (mean difference [MD]: -7.52, 95% confidence interval [95% CI]: -14.76 to -0.29, p = 0.04; MD: -5.74, 95% CI: -10.14 to -1.34, p = 0.01). During the operation, cardioplegia volume and blood glucose level were lower in the del Nido group (MD: -522.53, 95% CI: -926.68 to -118.37, p = 0.01; standardized mean difference [SMD]: -1.11, 95% CI: -1.74 to -0.48, p = 0.0006). Ventilation time and length of intensive care unit were decreased significantly with del Nido cardioplegia (MD: -1.05, 95% CI: -1.79 to -0.31, p = 0.006; MD: -0.65, 95% CI: -0.92 to -0.38, p < 0.00001). There were no differences in myocardial enzyme, postoperative inotropic support, atrial fibrillation, hospital, and mortality between the two groups. In adult cardiac surgery, myocardial protection used with the del Nido or conventional cardioplegia solution yield similar short-term clinical outcomes.
心脏停搏液是心脏手术中心肌保护的重要策略。本荟萃分析旨在比较 Del Nido 和传统心脏停搏液在成年患者中的作用。通过 PubMed、Embase、Cochrane 图书馆和国际临床试验注册平台进行了系统检索，以确定使用的研究。共纳入 9 项研究。与传统心脏停搏液相比，Del Nido 心脏停搏液的体外循环和主动脉阻断时间明显更短（平均差[MD]：-7.52，95%置信区间[95%CI]：-14.76 至-0.29，p=0.04；MD：-5.74，95%CI：-10.14 至-1.34，p=0.01）。在手术过程中，Del Nido 组的心脏停搏液量和血糖水平较低（MD：-522.53，95%CI：-926.68 至-118.37，p=0.01；标准化均数差[SMD]：-1.11，95%CI：-1.74 至-0.48，p=0.0006）。与传统心脏停搏液相比，Del Nido 心脏停搏液可显著缩短机械通气时间和重症监护病房住院时间（MD：-1.05，95%CI：-1.79 至-0.31，p=0.006；MD：-0.65，95%CI：-0.92 至-0.38，p<0.00001）。两组间心肌酶、术后正性肌力支持、心房颤动、住院时间和死亡率无差异。在成人心脏手术中，使用 Del Nido 或传统心脏停搏液进行心肌保护可获得相似的短期临床结果。
