TY - JOUR
T1 - Nitric Oxide in Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials
AU - Sardo, S
AU - Osawa, EA
AU - Finco, G
AU - Gomes Galas, FRB
AU - de Almeida, JP
AU - Cutuli, SL
AU - Frassanito, C
AU - Landoni, G
AU - Hajjar, LA
PY - 2018
Y1 - 2018
N2 - 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. © 2018 Elsevier Inc.
AB - 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. © 2018 Elsevier Inc.
U2 - 10.1053/j.jvca.2018.02.003
DO - 10.1053/j.jvca.2018.02.003
M3 - Article
VL - 32
SP - 2512
EP - 2519
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 6
ER -