Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis
Cardiopulmonary bypass (CPB) technology provides potential for cardiac surgery, but it is followed by myocardial injury and inflammation related to ischemia–reperfusion. This meta-analysis aimed to systematically evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery under CPB an...
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| Veröffentlicht in: | Journal of anesthesia 2022-02, Vol.36 (1), p.5-16 |
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| creator | Chen, Milian Li, Xia Mu, Guo |
| description | Cardiopulmonary bypass (CPB) technology provides potential for cardiac surgery, but it is followed by myocardial injury and inflammation related to ischemia–reperfusion. This meta-analysis aimed to systematically evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery under CPB and its effect on accompanied inflammation. PubMed, Cochrane Library, EMBASE and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) published before April 1st, 2021 that explored the application of dexmedetomidine in cardiac surgery. Compared with the control group (group C), the concentrations of CK-MB in the perioperative period and cTn-I at 12 h and 24 h after operation in dexmedetomidine group (group D) were significantly decreased (
P
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| doi_str_mv | 10.1007/s00540-021-02982-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8330189</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A691388861</galeid><sourcerecordid>A691388861</sourcerecordid><originalsourceid>FETCH-LOGICAL-c575t-ac249445d1b5eae271a66f03157960174eb8763ab7d2814821c6ca582774adef3</originalsourceid><addsrcrecordid>eNp9ktuK1TAUhosoznb0BbyQgDfedMyhh9QLYRg8wYg3eh3WTlc7GdqkJu0e95P5eq59cHBgIyUU8n_rz1rJn2UvBb8QnNdvE-dlwXMuBa1Gy5w_ylaiUDrXqmweZyveCJXrqtJn2bOUbjnnlRDqaXamClXIWspV9vvrNliIrYOBTTHMaGe3QQa-pTW73PlugHGEOcQtw64jPbHQsRZ_jdjiHEbXOo_MeTbB7NCTvPgWYx-c79neOmwg2WWAyNISeySjOzffHLVpGcbggTbX2wlSeseApW2akc50lkXcOLzb9zPiDDl4GLbJpefZkw6GhC-O__Psx8cP368-59ffPn25urzObVmXcw5WFk1RlK1YlwgoawFV1XElyrqpuKgLXOu6UrCuW6lFoaWwlYVSy7ouoMVOnWfvD77TsqaBLQ0YYTBTdCP1bAI481Dx7sb0YWO0UlzohgzeHA1i-Llgms3oksVhAI9hSUaW1GhRVWKHvj6gPQxo6OYDOdodbi4rekqtdSWIyk9QPXqk44PHztH2A_7iBE9fi6OzJwvkocDGkFLE7n5awc0ueOYQPEPBM_vgGU5Fr_69p_uSv0kjQB2ARJKnFJjbsER6zfQ_2z9hoOj6</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557546619</pqid></control><display><type>article</type><title>Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Chen, Milian ; Li, Xia ; Mu, Guo</creator><creatorcontrib>Chen, Milian ; Li, Xia ; Mu, Guo</creatorcontrib><description>Cardiopulmonary bypass (CPB) technology provides potential for cardiac surgery, but it is followed by myocardial injury and inflammation related to ischemia–reperfusion. This meta-analysis aimed to systematically evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery under CPB and its effect on accompanied inflammation. PubMed, Cochrane Library, EMBASE and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) published before April 1st, 2021 that explored the application of dexmedetomidine in cardiac surgery. Compared with the control group (group C), the concentrations of CK-MB in the perioperative period and cTn-I at 12 h and 24 h after operation in dexmedetomidine group (group D) were significantly decreased (
P
< 0.05). In addition, in group D, the levels of interleukin-6 at 24 h after operation, tumor necrosis factor-a at the 12 h and 24 h after operation were significantly decreased (
P
< 0.05). At the same time, the length of Intensive Care Unit stay in group D was significantly shorter than group C (
P
< 0.05). However, there was no significant difference in interleukin-10 level, C reactive protein level, the time on ventilator and length of hospital stay between the two groups (
P
> 0.05). The application of dexmedetomidine in cardiac surgery with CPB can reduce CK-MB and cTn-I concentration and interleukin-6, tumor necrosis factor-α levels to a certain extent and shorten the length of Intensive Care Unit stay, but it has no significant effect on IL-10 level, C reactive protein level, the time on ventilator and length of hospital stay.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-021-02982-0</identifier><identifier>PMID: 34342722</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Anesthesiology ; Anti-Inflammatory Agents ; Anti-inflammatory drugs ; C-reactive protein ; Cardiac patients ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Cisatracurium ; Comparative analysis ; Coronary artery bypass ; Critical Care Medicine ; Dexmedetomidine ; Dexmedetomidine - pharmacology ; Dexmedetomidine - therapeutic use ; Emergency Medicine ; Humans ; Inflammation ; Intensive ; Interleukins ; Ischemia ; Length of Stay ; Medicine ; Medicine & Public Health ; Online databases ; Pain Medicine ; Review ; Review Article ; Sufentanil ; Surgery ; Vecuronium</subject><ispartof>Journal of anesthesia, 2022-02, Vol.36 (1), p.5-16</ispartof><rights>Japanese Society of Anesthesiologists 2021</rights><rights>2021. Japanese Society of Anesthesiologists.</rights><rights>COPYRIGHT 2022 Springer</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c575t-ac249445d1b5eae271a66f03157960174eb8763ab7d2814821c6ca582774adef3</citedby><cites>FETCH-LOGICAL-c575t-ac249445d1b5eae271a66f03157960174eb8763ab7d2814821c6ca582774adef3</cites><orcidid>0000-0002-4919-7305</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-021-02982-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-021-02982-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34342722$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Milian</creatorcontrib><creatorcontrib>Li, Xia</creatorcontrib><creatorcontrib>Mu, Guo</creatorcontrib><title>Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Cardiopulmonary bypass (CPB) technology provides potential for cardiac surgery, but it is followed by myocardial injury and inflammation related to ischemia–reperfusion. This meta-analysis aimed to systematically evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery under CPB and its effect on accompanied inflammation. PubMed, Cochrane Library, EMBASE and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) published before April 1st, 2021 that explored the application of dexmedetomidine in cardiac surgery. Compared with the control group (group C), the concentrations of CK-MB in the perioperative period and cTn-I at 12 h and 24 h after operation in dexmedetomidine group (group D) were significantly decreased (
P
< 0.05). In addition, in group D, the levels of interleukin-6 at 24 h after operation, tumor necrosis factor-a at the 12 h and 24 h after operation were significantly decreased (
P
< 0.05). At the same time, the length of Intensive Care Unit stay in group D was significantly shorter than group C (
P
< 0.05). However, there was no significant difference in interleukin-10 level, C reactive protein level, the time on ventilator and length of hospital stay between the two groups (
P
> 0.05). The application of dexmedetomidine in cardiac surgery with CPB can reduce CK-MB and cTn-I concentration and interleukin-6, tumor necrosis factor-α levels to a certain extent and shorten the length of Intensive Care Unit stay, but it has no significant effect on IL-10 level, C reactive protein level, the time on ventilator and length of hospital stay.</description><subject>Anesthesiology</subject><subject>Anti-Inflammatory Agents</subject><subject>Anti-inflammatory drugs</subject><subject>C-reactive protein</subject><subject>Cardiac patients</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiopulmonary Bypass</subject><subject>Cisatracurium</subject><subject>Comparative analysis</subject><subject>Coronary artery bypass</subject><subject>Critical Care Medicine</subject><subject>Dexmedetomidine</subject><subject>Dexmedetomidine - pharmacology</subject><subject>Dexmedetomidine - therapeutic use</subject><subject>Emergency Medicine</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Intensive</subject><subject>Interleukins</subject><subject>Ischemia</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Online databases</subject><subject>Pain Medicine</subject><subject>Review</subject><subject>Review Article</subject><subject>Sufentanil</subject><subject>Surgery</subject><subject>Vecuronium</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ktuK1TAUhosoznb0BbyQgDfedMyhh9QLYRg8wYg3eh3WTlc7GdqkJu0e95P5eq59cHBgIyUU8n_rz1rJn2UvBb8QnNdvE-dlwXMuBa1Gy5w_ylaiUDrXqmweZyveCJXrqtJn2bOUbjnnlRDqaXamClXIWspV9vvrNliIrYOBTTHMaGe3QQa-pTW73PlugHGEOcQtw64jPbHQsRZ_jdjiHEbXOo_MeTbB7NCTvPgWYx-c79neOmwg2WWAyNISeySjOzffHLVpGcbggTbX2wlSeseApW2akc50lkXcOLzb9zPiDDl4GLbJpefZkw6GhC-O__Psx8cP368-59ffPn25urzObVmXcw5WFk1RlK1YlwgoawFV1XElyrqpuKgLXOu6UrCuW6lFoaWwlYVSy7ouoMVOnWfvD77TsqaBLQ0YYTBTdCP1bAI481Dx7sb0YWO0UlzohgzeHA1i-Llgms3oksVhAI9hSUaW1GhRVWKHvj6gPQxo6OYDOdodbi4rekqtdSWIyk9QPXqk44PHztH2A_7iBE9fi6OzJwvkocDGkFLE7n5awc0ueOYQPEPBM_vgGU5Fr_69p_uSv0kjQB2ARJKnFJjbsER6zfQ_2z9hoOj6</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Chen, Milian</creator><creator>Li, Xia</creator><creator>Mu, Guo</creator><general>Springer Singapore</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4919-7305</orcidid></search><sort><creationdate>20220201</creationdate><title>Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis</title><author>Chen, Milian ; Li, Xia ; Mu, Guo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c575t-ac249445d1b5eae271a66f03157960174eb8763ab7d2814821c6ca582774adef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anesthesiology</topic><topic>Anti-Inflammatory Agents</topic><topic>Anti-inflammatory drugs</topic><topic>C-reactive protein</topic><topic>Cardiac patients</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiopulmonary Bypass</topic><topic>Cisatracurium</topic><topic>Comparative analysis</topic><topic>Coronary artery bypass</topic><topic>Critical Care Medicine</topic><topic>Dexmedetomidine</topic><topic>Dexmedetomidine - pharmacology</topic><topic>Dexmedetomidine - therapeutic use</topic><topic>Emergency Medicine</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Intensive</topic><topic>Interleukins</topic><topic>Ischemia</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Online databases</topic><topic>Pain Medicine</topic><topic>Review</topic><topic>Review Article</topic><topic>Sufentanil</topic><topic>Surgery</topic><topic>Vecuronium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Milian</creatorcontrib><creatorcontrib>Li, Xia</creatorcontrib><creatorcontrib>Mu, Guo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Milian</au><au>Li, Xia</au><au>Mu, Guo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>36</volume><issue>1</issue><spage>5</spage><epage>16</epage><pages>5-16</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Cardiopulmonary bypass (CPB) technology provides potential for cardiac surgery, but it is followed by myocardial injury and inflammation related to ischemia–reperfusion. This meta-analysis aimed to systematically evaluate the cardioprotective effect of dexmedetomidine on cardiac surgery under CPB and its effect on accompanied inflammation. PubMed, Cochrane Library, EMBASE and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) published before April 1st, 2021 that explored the application of dexmedetomidine in cardiac surgery. Compared with the control group (group C), the concentrations of CK-MB in the perioperative period and cTn-I at 12 h and 24 h after operation in dexmedetomidine group (group D) were significantly decreased (
P
< 0.05). In addition, in group D, the levels of interleukin-6 at 24 h after operation, tumor necrosis factor-a at the 12 h and 24 h after operation were significantly decreased (
P
< 0.05). At the same time, the length of Intensive Care Unit stay in group D was significantly shorter than group C (
P
< 0.05). However, there was no significant difference in interleukin-10 level, C reactive protein level, the time on ventilator and length of hospital stay between the two groups (
P
> 0.05). The application of dexmedetomidine in cardiac surgery with CPB can reduce CK-MB and cTn-I concentration and interleukin-6, tumor necrosis factor-α levels to a certain extent and shorten the length of Intensive Care Unit stay, but it has no significant effect on IL-10 level, C reactive protein level, the time on ventilator and length of hospital stay.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>34342722</pmid><doi>10.1007/s00540-021-02982-0</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-4919-7305</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesiology Anti-Inflammatory Agents Anti-inflammatory drugs C-reactive protein Cardiac patients Cardiac Surgical Procedures Cardiopulmonary Bypass Cisatracurium Comparative analysis Coronary artery bypass Critical Care Medicine Dexmedetomidine Dexmedetomidine - pharmacology Dexmedetomidine - therapeutic use Emergency Medicine Humans Inflammation Intensive Interleukins Ischemia Length of Stay Medicine Medicine & Public Health Online databases Pain Medicine Review Review Article Sufentanil Surgery Vecuronium |
| title | Myocardial protective and anti-inflammatory effects of dexmedetomidine in patients undergoing cardiovascular surgery with cardiopulmonary bypass: a systematic review and meta-analysis |
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