HTK solution cardioplegia in paediatric patients: a meta-analysis.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Thoracic and Cardiovascular Surgeon Pub Date : 2024-11-05 DOI:10.1055/a-2461-3147
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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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.

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儿科患者的 HTK 溶液心脏麻痹:一项荟萃分析。
简介心脏麻痹是一种旨在诱导可逆性心脏停搏的疗法,它彻底改变了心血管外科手术。组氨酸-色氨酸-酮戊二酸(HTK)溶液是各种药理学方法中的一种。尽管有许多研究,但还没有一项荟萃分析调查了 HTK 溶液在儿科人群中的疗效。因此,我们旨在对接受心血管手术的儿科患者进行一项荟萃分析,比较 HTK 和其他心脏麻痹溶液:方法:检索了从开始到 2024 年 4 月的 PubMed、Embase 和 Cochrane 数据库。对于二分变量,终点以几率比(OR)和95%置信区间(CI)计算,而连续变量则以平均差(MD)和95%置信区间进行比较:结果:共纳入了 11 项研究,1,349 名患者,其中 677 人(50.19%)接受了 HTK 心脏麻痹。在死亡率(OR 0.98;95% CI 0.29,3.29)、住院时间(MD 0.32 天;95% CI -0.88,1.51)、MV(MD -17.72小时;95% IC -51.29,15.85)、心律失常(OR 1.27;95% CI 0.83,1.95;)和胸骨闭合延迟(OR 0.89;95% 0.56,1.43)方面,各组结果相似。然而,HTK 组的输血量较低(MD -452.39;95% CI -890.24,-14.53;P=0.04):结论:HTK溶液的临床疗效与其他心脏麻痹方法相似,对易发生高血容量的患者有一定优势。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
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.
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