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

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art_SARDO_Nitric_Oxide_in_Cardiac_Surgery_A_MetaAnalysis_of_2018.PDF (864.26 KB)
Citações na Scopus
26
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
SARDO, Salvatore
FINCO, Gabriele
CUTULI, Salvatore Lucio
FRASSANITO, Claudia
LANDONI, Giovanni
Citação
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, v.32, n.6, p.2512-2519, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
nitric oxide, cardiac, pulmonary hypertension, meta-analysis, vasodilator, cardiopulmonary bypass
URI
https://observatorio.fm.usp.br/handle/OPI/29783
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - ODS/03