用于儿童心脏手术的外科手术预防性皮质类固醇:系统性审查和元分析
Huzaifa Ahmad Cheema1, Arsalan Ali Khan2, Awab Hussain Ahmad2
1Department of Cardiology, King Edward Medical University, Lahore, Pakistan; Department of Medicine, King Edward Medical University, Lahore, Pakistan.
American heart journal
|September 16, 2023
概括
在儿科心脏外科手术中,外科皮质类固醇显示出降低死亡率的趋势,并显著减少机械通风持续时间. 它们还可以减少低心输出综合征和重复手术,从而增加高血糖症的风险.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 药理学 药理学 是一个学科.
背景情况:
- 在儿科心脏外科手术中经常使用外科皮质类固醇.
- 支持其有效性和安全性的证据仍然相互矛盾.
研究的目的:
- 在儿科心脏手术中调查外科手术期间预防性皮质类固醇的疗效和安全性.
主要方法:
- 对12项随机对照试验 (RCT) 的系统审查,涉及2,209名患者.
- 使用RevMan 5.4进行数据分析,以组合风险比率 (RR) 和平均差异 (MD).
- 在2023年3月之前搜索电子数据库.
主要成果:
- 皮质类固醇显示所有原因死亡率的非显著降低 (RR 0.62).
- 与减少机械通风持续时间 (MD -0.63天) 和较低的心力输出综合征 (LCOS) (RR 0.76) 和重复手术 (RR 0.37) 的发病率相关.
- 没有显著影响ICU或住院;高血糖和胰岛素使用的风险增加.
结论:
- 在儿科心脏外科手术中使用外科皮质类固醇表明死亡率下降的趋势.
- 已被证明可以减少机械通风的持续时间,LCOS和重新操作.
- 需要进一步的研究来确定最佳的皮质类固醇剂,剂量和患者选择.
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