To compare the outcomes of patients receiving del Nido solution versus any other type of cardioplegia.
A systematic review and meta-analysis of randomized trials.
Cardiac surgery theatres.
Adult patients (≥18 years old) undergoing cardiac surgery.
The EMBASE, MEDLINE, and CENTRAL databases were systematically searched from their inception until August 2022 for randomized controlled trials comparing del Nido versus other cardioplegia.
Measurements and main results
Ten studies including 1,812 patients (871 in the del Nido group and 941 in the control group) and published after 2017 were included. There was a significant reduction in postoperative stroke/transient ischemic attack rate in the del Nido group: 9/467 (1.9%) vs 25/540 (4.6%); odds ratio, 0.43; 95% confidence interval, 0.20-0.92 (p=0.007). Del Nido cardioplegia was also associated with significantly shorter aortic cross-clamp time (mean difference, -8.99 minutes; 95% CI, -17.24 to -0.73 [p<0.001]), significantly reduced need for defibrillation (89/582 (15%) vs 252/655 (38%); odds ratio, 0.33; 95% confidence interval, 0.15-0.72 [p<0.001]), significantly lower risk of postoperative acute kidney injury (21/235 (8.9%) vs 34/301 (11%); odds ratio, 0.50; 95% confidence interval, 0.26-0.97 [p=0.04]) with no effect on mortality (14/607 (2.3%) vs 12/681 (1.8%); p=0.5).
According to our meta-analysis of recent randomized clinical trials, del Nido is a safe cardioplegic solution which might provide better organ protection in adult cardiac surgery without differences in mortality when compared to other cardioplegic solutions.
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