Abouzid Mohamed, Roshdy Yara, Daniel John Magdy, Rzk Fayed Mohamed, Ismeal Ali Ahmed Ali, Hendawy Mohamed, Tanashat Mohammad, Elnagar Marwa, Daoud Nada, Ramadan Alaa
Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806, Poznan, Poland.
Doctoral School, Poznan University of Medical Sciences, 60-812, Poznan, Poland.
Eur J Clin Pharmacol. 2023 Nov;79(11):1425-1442. doi: 10.1007/s00228-023-03554-9. Epub 2023 Aug 31.
Investigate inhaled nitric oxide's influence on mortality rates, mechanical ventilation and cardiopulmonary bypass duration, and length of stay in the intensive care unit and hospital when administered during cardiopulmonary bypass.
Following the PRISMA guidelines, we searched four electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science) up to 4th March 2023. The protocol was registered in the PROSPERO database with ID: CRD42023423007. Using Review Manager software, we reported outcomes as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs).
The meta-analysis included a total of 17 studies with 2897 patients. Overall, there were no significant differences in using nitric oxide over control concerning mortality (RR = 1.03, 95% CI 0.73 to 1.45; P = 0.88) or cardiopulmonary bypass duration (MD = -0.14, 95% CI - 0.96 to 0.69; P = 0.74). The intensive care unit days were significantly lower in the nitric oxide group than control (MD = -0.80, 95% CI - 1.31 to -0.29; P = 0.002). Difference results were obtained in terms of the length of stay in the hospital according to sensitivity analysis (without sensitivity [MD = -0.41, 95% CI - 0.79 to -0.02; P = 0.04] vs. with sensitivity [MD = -0.31, 95% CI - 0.69 to 0.07; P = 0.11]. Subgroup analysis shows that, in children, nitric oxide was favored over control in significantly reducing the duration of mechanical ventilation (MD = -4.58, 95% CI - 5.63 to -3.53; P < 0.001).
Using inhaled nitric oxide during cardiopulmonary bypass reduces the length of stay in the intensive care unit, and for children, it reduces the duration of mechanical ventilation.
研究体外循环期间吸入一氧化氮对死亡率、机械通气时间、体外循环持续时间以及重症监护病房和医院住院时间的影响。
按照PRISMA指南，我们检索了截至2023年3月4日的四个电子数据库（PubMed、EMBASE、Cochrane图书馆和Web of Science）。该方案已在PROSPERO数据库中注册，编号为：CRD42023423007。使用Review Manager软件，我们将结果报告为风险比（RRs）或平均差（MD）以及置信区间（CIs）。
荟萃分析共纳入17项研究，涉及2897例患者。总体而言，与对照组相比，使用一氧化氮在死亡率（RR = 1.03，95% CI 0.73至1.45；P = 0.88）或体外循环持续时间（MD = -0.14，95% CI -0.96至0.69；P = 0.74）方面无显著差异。一氧化氮组的重症监护病房住院天数显著低于对照组（MD = -0.80，95% CI -1.31至-0.29；P = 0.002）。根据敏感性分析，在住院时间方面得到了不同的结果（不进行敏感性分析时[MD = -0.41，95% CI -0.79至-0.02；P = 0.04]与进行敏感性分析时[MD = -0.31，95% CI -0.69至0.07；P = 0.11]）。亚组分析表明，在儿童中，一氧化氮在显著缩短机械通气时间方面优于对照组（MD = -4.58，95% CI -5.63至-3.53；P < 0.001）。
体外循环期间使用吸入一氧化氮可缩短重症监护病房的住院时间，对于儿童而言，可缩短机械通气时间。
