ABSTRACT
Objective
To compare the outcomes of patients receiving del Nido solution versus any other type
of cardioplegia.
Design
A systematic review and meta-analysis of randomized trials.
Setting
Cardiac surgery theatres.
Participants
Adult patients (≥18 years old) undergoing cardiac surgery.
Interventions
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).
Conclusion
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.
Graphical Abstract
Graphical Abstract
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
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