Del Nido versus conventional blood cardioplegia in tetralogy of fallot repair: A systematic review and meta-analysis of randomized controlled trials.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Perfusion-Uk Pub Date : 2025-01-05 DOI:10.1177/02676591241312380

Leo Noanh Consoli, Ilias Georgios Koziakas, Meletios Kanakis

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引用次数: 0

Abstract

Objectives: Compare outcomes of Del Nido (DN) versus conventional blood cardioplegia (BC) in the surgical repair of Tetralogy of Fallot (ToF).

Methods: Medical databases were searched to identify relevant clinical trials. Meta-analysis was conducted for primary (cardiopulmonary bypass [CPB] and aortic cross-clamp [ACC] times, hospital and intensive care unit [ICU] length of stay [LOS], mechanical ventilation time) and secondary (adverse events, lactate levels, volume of additional cardioplegia) endpoints. Analysis was conducted for DN versus conventional blood cardioplegia, and we performed sensitivity analysis with leave one-out analysis for the primary outcome.

Results: 4 randomized controlled trials were included (n = 275). Mean differences (MD) with 95% confidence intervals (CI) were calculated with a random-effects model. Groups had similar CPB (MD -5.76 minutes; [-23.32 to 11.80]; p = 0.52) and ACC (MD 3.06 minutes; [-13.64 to 7.52]; p = 0.57) times, ICU (MD -6.42 hours; [-25.62 to 12.78]; p = 0.51) LOS and additional cardioplegia volume (MD -195.18 mL; [-434.19 to 43.82]; p = 0.11). The DN group had shorter hospital LOS (MD -0.81 days; [-1.25 to -0.36]; p = 0.0003) and time under mechanical ventilation (MD -4.57 hours; [-8.73 to -0.42]; p = 0.03). There was no difference in mortality.

Conclusions: DN cardioplegia has similar clinical outcomes and operative times compared to conventional blood cardioplegia in ToF surgery.

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在法洛四联症修复中，Del Nido与传统血液停搏：随机对照试验的系统回顾和荟萃分析。

目的：比较Del Nido （DN）与常规血液停搏（BC）在法洛四联症（ToF）手术修复中的效果。方法：检索医学数据库，查找相关临床试验。对主要终点（体外循环[CPB]和主动脉交叉夹夹[ACC]次数、住院和重症监护病房[ICU]住院时间[LOS]、机械通气时间）和次要终点（不良事件、乳酸水平、额外心脏骤停量）进行meta分析。对DN与常规血液心脏骤停进行了分析，我们对主要结局进行了敏感性分析，留一分析。结果：纳入4项随机对照试验（n = 275）。采用随机效应模型计算95%置信区间（CI）的均值差（MD）。各组CPB相似(MD -5.76分钟；[-23.32 - 11.80]；p = 0.52)和ACC (MD 3.06分钟；[-13.64 - 7.52]；p = 0.57)次，ICU (MD -6.42 h；[-25.62至12.78]；p = 0.51) LOS和额外心脏骤停容积(MD -195.18 mL；[-434.19 - 43.82]；P = 0.11)。DN组住院时间较短(MD -0.81 d；[-1.25至-0.36]；p = 0.0003)和机械通气时间(MD -4.57 h；[-8.73至-0.42]；P = 0.03)。死亡率没有差别。结论：在ToF手术中，与常规血液停搏相比，DN停搏具有相似的临床效果和手术时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perfusion-Uk 医学-外周血管病

CiteScore

3.00

自引率

8.30%

发文量

203

审稿时长

6-12 weeks

期刊介绍： Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.