Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial
Background Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. Methods The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2023-12-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-22787.pdf |
| _version_ | 1797447983413854208 |
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| author | Lin Yang Yongheng Cai Lin Dan He Huang Bing Chen |
| author_facet | Lin Yang Yongheng Cai Lin Dan He Huang Bing Chen |
| author_sort | Lin Yang |
| collection | DOAJ |
| description | Background Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. Methods The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and Chinese Clinical Trial Registry databases were systematically searched. The primary outcome was oxygenation index (OI). Other outcomes including the incidence of postoperative complications were assessed. Results Fourteen randomized controlled trials involving 845 patients were included in this meta-analysis. Dexmedetomidine improved the OI at 30 (mean difference [MD]: 40.49, 95% CI [10.21, 70.78]), 60 (MD: 60.86, 95% CI [35.81, 85.92]), and 90 min (MD: 55, 95% CI [34.89, 75.11]) after OLV and after surgery (MD: 28.98, 95% CI [17.94, 40.0]) and improved lung compliance 90 min after OLV (MD: 3.62, 95% CI [1.7, 5.53]). Additionally, dexmedetomidine reduced the incidence of postoperative pulmonary complications (odds ratio: 0.44, 95% CI [0.24, 0.82]) and length of hospital stay (MD: −0.99, 95% CI [−1.25, −0.73]); decreased tumor necrosis factor-α, interleukin (IL)-6, IL-8, and malondialdehyde levels; and increased superoxide dismutase levels. However, only the results for the OI and IL-6 levels were confirmed by the sensitivity and trial sequential analyses. Conclusions Dexmedetomidine improves oxygenation in patients receiving OLV and may additionally decrease the incidence of postoperative pulmonary complications and shorten the length of hospital stay, which may be related to associated improvements in lung compliance, anti-inflammatory effects, and regulation of oxidative stress reactions. However, robust evidence is required to confirm these conclusions. |
| first_indexed | 2024-03-09T14:03:48Z |
| format | Article |
| id | doaj.art-547b5c2332064c14b052566b7d9ce452 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-03-09T14:03:48Z |
| publishDate | 2023-12-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-547b5c2332064c14b052566b7d9ce4522023-11-30T05:20:04ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632023-12-0176658659610.4097/kja.227878895Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trialLin Yang0Yongheng Cai1Lin Dan2He Huang3Bing Chen Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China Department of Anesthesiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaBackground Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. Methods The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and Chinese Clinical Trial Registry databases were systematically searched. The primary outcome was oxygenation index (OI). Other outcomes including the incidence of postoperative complications were assessed. Results Fourteen randomized controlled trials involving 845 patients were included in this meta-analysis. Dexmedetomidine improved the OI at 30 (mean difference [MD]: 40.49, 95% CI [10.21, 70.78]), 60 (MD: 60.86, 95% CI [35.81, 85.92]), and 90 min (MD: 55, 95% CI [34.89, 75.11]) after OLV and after surgery (MD: 28.98, 95% CI [17.94, 40.0]) and improved lung compliance 90 min after OLV (MD: 3.62, 95% CI [1.7, 5.53]). Additionally, dexmedetomidine reduced the incidence of postoperative pulmonary complications (odds ratio: 0.44, 95% CI [0.24, 0.82]) and length of hospital stay (MD: −0.99, 95% CI [−1.25, −0.73]); decreased tumor necrosis factor-α, interleukin (IL)-6, IL-8, and malondialdehyde levels; and increased superoxide dismutase levels. However, only the results for the OI and IL-6 levels were confirmed by the sensitivity and trial sequential analyses. Conclusions Dexmedetomidine improves oxygenation in patients receiving OLV and may additionally decrease the incidence of postoperative pulmonary complications and shorten the length of hospital stay, which may be related to associated improvements in lung compliance, anti-inflammatory effects, and regulation of oxidative stress reactions. However, robust evidence is required to confirm these conclusions.http://ekja.org/upload/pdf/kja-22787.pdfartificial respirationdexmedetomidinemeta-analysisone-lung ventilationpostoperative complicationsrespiratory mechanics |
| spellingShingle | Lin Yang Yongheng Cai Lin Dan He Huang Bing Chen Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial Korean Journal of Anesthesiology artificial respiration dexmedetomidine meta-analysis one-lung ventilation postoperative complications respiratory mechanics |
| title | Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial |
| title_full | Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial |
| title_fullStr | Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial |
| title_full_unstemmed | Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial |
| title_short | Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial |
| title_sort | effects of dexmedetomidine on pulmonary function in patients receiving one lung ventilation a meta analysis of randomized controlled trial |
| topic | artificial respiration dexmedetomidine meta-analysis one-lung ventilation postoperative complications respiratory mechanics |
| url | http://ekja.org/upload/pdf/kja-22787.pdf |
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