Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective
Objective: This meta-analysis aimed to compare clinical outcomes of warm and cold cardioplegia in cardiac surgeries in adult patients, with trial sequential analysis (TSA) used to determine the conclusiveness of the results. Methods: Electronic searches were performed on PubMed, Medline, Scopus, EMB...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273621000681 |
| _version_ | 1818775415923146752 |
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| author | Thompson Ka Ming Kot, MBChB Jeffrey Shi Kai Chan, MBChB Saied Froghi, MRCS Dawnie Ho Hei Lau, MBChB Kara Morgan, MPharm, MSc, PGHE Francesco Magni, BSc Amer Harky, MRCS, MSc |
| author_facet | Thompson Ka Ming Kot, MBChB Jeffrey Shi Kai Chan, MBChB Saied Froghi, MRCS Dawnie Ho Hei Lau, MBChB Kara Morgan, MPharm, MSc, PGHE Francesco Magni, BSc Amer Harky, MRCS, MSc |
| author_sort | Thompson Ka Ming Kot, MBChB |
| collection | DOAJ |
| description | Objective: This meta-analysis aimed to compare clinical outcomes of warm and cold cardioplegia in cardiac surgeries in adult patients, with trial sequential analysis (TSA) used to determine the conclusiveness of the results. Methods: Electronic searches were performed on PubMed, Medline, Scopus, EMBASE, and Cochrane library to identify all studies that compared warm and cold cardioplegia in cardiac surgeries. Primary end points were in-hospital or 30-day mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, and new atrial fibrillation. Secondary end points were acute kidney injury, hospital length of stay, and intensive care unit length of stay. Prespecified subgroup analyses were performed for (1) studies published since publication of Fan and colleagues in 2010, (2) randomized controlled studies, (3) studies with low risk of bias, (4) coronary artery bypass graft surgeries, and (5) studies with cold blood versus those with cold crystalloid cardioplegia. TSA was performed to determine conclusiveness of the results, using on all outcomes without significant heterogeneity from studies of low risk of bias. Results: No significant differences were found between post-operative rates of mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, new atrial fibrillation, and acute kidney injury between warm and cold cardioplegia. TSA concluded that current evidence was sufficient to rule out a 20% relative risk reduction in these outcomes. Conclusions: Concerning safety outcomes, current evidence suggests that the choice between warm and cold cardioplegia remains in the surgeon's preference. |
| first_indexed | 2024-12-18T10:56:41Z |
| format | Article |
| id | doaj.art-21a5c08aa22e4ba38527a331fc0fa20c |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-12-18T10:56:41Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-21a5c08aa22e4ba38527a331fc0fa20c2022-12-21T21:10:19ZengElsevierJTCVS Open2666-27362021-06-016161190Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspectiveThompson Ka Ming Kot, MBChB0Jeffrey Shi Kai Chan, MBChB1Saied Froghi, MRCS2Dawnie Ho Hei Lau, MBChB3Kara Morgan, MPharm, MSc, PGHE4Francesco Magni, BSc5Amer Harky, MRCS, MSc6Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, New Territories, Hong KongFaculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong KongDivision of Surgery and Interventional Sciences, Royal Free Hospital, University College London, London, United KingdomFaculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong KongDepartment of Cardiology, Manchester Royal Infirmary, Manchester, United Kingdom; Faculty of Biology, Medicine & Health, Division of Pharmacy & Optometry, School of Health Sciences, The University of Manchester, Manchester, United KingdomFaculty of Medicine, University College London, London, United Kingdom; Address for reprints: Francesco Magni, University College London Medical School, London, United Kingdom.Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United KingdomObjective: This meta-analysis aimed to compare clinical outcomes of warm and cold cardioplegia in cardiac surgeries in adult patients, with trial sequential analysis (TSA) used to determine the conclusiveness of the results. Methods: Electronic searches were performed on PubMed, Medline, Scopus, EMBASE, and Cochrane library to identify all studies that compared warm and cold cardioplegia in cardiac surgeries. Primary end points were in-hospital or 30-day mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, and new atrial fibrillation. Secondary end points were acute kidney injury, hospital length of stay, and intensive care unit length of stay. Prespecified subgroup analyses were performed for (1) studies published since publication of Fan and colleagues in 2010, (2) randomized controlled studies, (3) studies with low risk of bias, (4) coronary artery bypass graft surgeries, and (5) studies with cold blood versus those with cold crystalloid cardioplegia. TSA was performed to determine conclusiveness of the results, using on all outcomes without significant heterogeneity from studies of low risk of bias. Results: No significant differences were found between post-operative rates of mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, new atrial fibrillation, and acute kidney injury between warm and cold cardioplegia. TSA concluded that current evidence was sufficient to rule out a 20% relative risk reduction in these outcomes. Conclusions: Concerning safety outcomes, current evidence suggests that the choice between warm and cold cardioplegia remains in the surgeon's preference.http://www.sciencedirect.com/science/article/pii/S2666273621000681cardiac surgeriescold cardioplegiawarm cardioplegiameta-analysistrial sequential analysis |
| spellingShingle | Thompson Ka Ming Kot, MBChB Jeffrey Shi Kai Chan, MBChB Saied Froghi, MRCS Dawnie Ho Hei Lau, MBChB Kara Morgan, MPharm, MSc, PGHE Francesco Magni, BSc Amer Harky, MRCS, MSc Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective JTCVS Open cardiac surgeries cold cardioplegia warm cardioplegia meta-analysis trial sequential analysis |
| title | Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective |
| title_full | Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective |
| title_fullStr | Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective |
| title_full_unstemmed | Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective |
| title_short | Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysisCentral MessagePerspective |
| title_sort | warm versus cold cardioplegia in cardiac surgery a meta analysis with trial sequential analysiscentral messageperspective |
| topic | cardiac surgeries cold cardioplegia warm cardioplegia meta-analysis trial sequential analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666273621000681 |
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