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Nitric Oxide in Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials.

Abstract：

OBJECTIVES:To investigate the efficacy and safety of perioperative administration of nitric oxide in cardiac surgery. DESIGN:Meta-analysis of randomized controlled trials (RCTs). PARTICIPANTS:Cardiac surgery patients. INTERVENTIONS:A search of Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and MEDLINE for RCTs that compared nitric oxide with placebo or other comparators. MEASUREMENTS AND MAIN RESULTS:The primary outcome was intensive care unit (ICU) stay, and secondary outcomes were mortality, duration of mechanical ventilation, and reduction of mean pulmonary artery pressure. The study included 18 RCTs comprising 958 patients. The authors calculated the pooled odds ratio (OR) and the mean difference (MD) with random-effects model. Quantitative synthesis of data demonstrated a clinically negligible reduction in the length of ICU stay (MD -0.38 days, confidence interval CI [-0.65 to -0.11]; p = 0.005) and mechanical ventilation duration (MD -4.81 hours, CI [-7.79 to -1.83]; p = 0.002) compared with all control interventions with no benefit on mortality. CONCLUSIONS:Perioperative delivery of inhaled nitric oxide resulted to be of no or minimal benefit in patients with pulmonary hypertension undergoing cardiac surgery. Large, randomized trials are needed to further assess its effect on major clinical outcomes and its cost-effectiveness.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Sardo S,Osawa EA,Finco G,Gomes Galas FRB,de Almeida JP,Cutuli SL,Frassanito C,Landoni G,Hajjar LA

doi

10.1053/j.jvca.2018.02.003

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

2512-2519

issue

6

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(18)30102-2

journal_volume

32

pub_type

杂志文章,meta分析,评审

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