Lorhayne Kerley Capuchinho Scalioni Galvao, Ana Clara Felix de Farias Santos, Nicole Pimenta Dos Santos, Fernanda Valeriano Zamora, Belisa Brunow Ventura Biavatti, João Pedro Costa Esteves Almuinha Salles, Horbert Soares Mendonca
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引用次数: 0
Abstract
Introduction: Cardioplegia, a therapy designed to induce reversible cardiac arrest, revolutionised cardiovascular surgery. Among the various pharmacological approaches is the histidine-tryptophan-ketoglutarate (HTK) solution. Despite numerous studies, no meta-analysis has investigated the efficacy of the HTK solution in the paediatric population. Therefore, we aim to conduct a meta-analysis comparing HTK and other cardioplegia solutions in paediatric patients undergoing cardiovascular surgery.
Methods: PubMed, Embase and Cochrane databases were searched from inception through April 2024. Endpoints were computed in odds ratios (OR) with 95% Confidence Intervals (CI) for dichotomous variables, whereas continuous variables were compared using mean differences (MD) with 95% CI.
Results: 11 studies comprising 1,349 patients were included, of whom 677 (50.19%) received HTK cardioplegia. The results were similar between groups regarding mortality (OR 0.98; 95% CI 0.29, 3.29), length of hospital (MD 0.32 days; 95% CI -0.88, 1.51), MV (MD -17.72 hours; 95% IC -51.29, 15.85), arrhythmias (OR 1.27; 95% CI 0.83, 1.95;) and delayed sternal closure (OR 0.89; 95% 0.56, 1.43). However, transfusion volume was lower in the HTK group (MD -452.39; 95% CI -890.24, -14.53; p=0.04).
Conclusion: The use of HTK solution was demonstrated to be similar regarding its clinical efficacy to other approaches for cardioplegia, and it may present advantages to patients prone to hypervolemia.
期刊介绍:
The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field.
Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.