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右美托咪定预防心脏手术后急性肾损伤的效果:一项更新的系统评价和荟萃分析。

Effect of dexmedetomidine for prevention of acute kidney injury after cardiac surgery: an updated systematic review and meta-analysis.

机构信息

Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Department of Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

出版信息

Ren Fail. 2022 Dec;44(1):1150-1159. doi: 10.1080/0886022X.2022.2097923.

Abstract

BACKGROUND

Acute kidney injury (AKI) is a serious complication related to cardiac surgery. Several studies have been conducted to investigate the effect of dexmedetomidine administration on AKI prevention.

OBJECTIVE

To assess if dexmedetomidine is associated with a protective effect of renal function after cardiac surgery. And the aim of conducting this meta-analysis is to summarize the literature and determine the clinical utility of dexmedetomidine administration in patients undergoing cardiac surgery.

METHODS

PubMed, Cochrane Library, and EMBASE databases were comprehensively searched for all randomized controlled trials (RCTs) published before 1 December, 2021 that investigated the effect of dexmedetomidine on AKI prevention.

RESULTS

Our analysis included 16 studies involving 2148 patients. Compared with the control group, dexmedetomidine administration significantly reduced AKI incidence (OR, 0.47; 95% CI, 0.36-0.61;  <  0.00001;  = 26%) and the length of stay in the intensive care unit (ICU) but did not alter mortality rate, length of stay in the hospital, and mechanical ventilation time. Furthermore, the incidence of delirium among patients treated with dexmedetomidine was significantly decreased.

CONCLUSION

Dexmedetomidine administration has a positive effect on preventing AKI and postoperative delirium after cardiac surgery and significantly reduces the length of stay in the ICU.

摘要

背景

急性肾损伤(AKI)是与心脏手术相关的严重并发症。已有多项研究探讨了右美托咪定给药对 AKI 预防的影响。

目的

评估右美托咪定是否对心脏手术后的肾功能具有保护作用。进行此荟萃分析的目的是总结文献并确定右美托咪定给药在心脏手术患者中的临床应用价值。

方法

全面检索 PubMed、Cochrane Library 和 EMBASE 数据库,以获取截至 2021 年 12 月 1 日发表的所有关于右美托咪定预防 AKI 的随机对照试验(RCT)。

结果

我们的分析纳入了 16 项研究,共计 2148 例患者。与对照组相比,右美托咪定给药显著降低 AKI 发生率(OR,0.47;95%CI,0.36-0.61; <  0.00001;  = 26%)和 ICU 住院时间,但不改变死亡率、住院时间和机械通气时间。此外,接受右美托咪定治疗的患者谵妄发生率显著降低。

结论

右美托咪定给药对预防心脏手术后 AKI 和术后谵妄具有积极作用,并显著缩短 ICU 住院时间。

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