The impact of exogenous nitric oxide during cardiopulmonary bypass for cardiac surgery
| Autor: | Lorraine P Browne, John Hinchion, Joseph Mc Loughlin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Cardiac Output Low 030204 cardiovascular system & hematology Nitric Oxide law.invention Nitric oxide 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Internal medicine medicine Cardiopulmonary bypass Humans Radiology Nuclear Medicine and imaging Cardiac Surgical Procedures Child Advanced and Specialized Nursing Cardioprotection Cardiopulmonary Bypass business.industry Troponin I 030208 emergency & critical care medicine General Medicine medicine.disease Cardiac surgery Systemic inflammatory response syndrome Low cardiac output syndrome chemistry Cardiology Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. 37(7) |
| ISSN: | 1477-111X |
| Popis: | Objectives: Cardiac surgery using cardiopulmonary bypass frequently provokes a systemic inflammatory response syndrome. This can lead to the development of low cardiac output syndrome (LCOS). Both of these can affect morbidity and mortality. This study is a systematic review of the impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary bypass (CPB) circuit during cardiac surgery, on post-operative outcomes. It aims to summarise the evidence available, to assess the effectiveness of gNO via the CPB circuit on outcomes, and highlight areas of further research needed to develop this hypothesis. Methods: A comprehensive search of Pubmed, Embase, Web of Science and the Cochrane Library was performed in May 2020. Only randomised control trials (RCTs) were considered. Results: Three studies were identified with a total of 274 patients. There was variation in the outcomes measures used across the studies. These studies demonstrate there is evidence that this intervention may contribute towards cardioprotection. Significant reductions in cardiac troponin I (cTnI) levels and lower vasoactive inotrope scores were seen in intervention groups. A high degree of heterogeneity between the studies exists. Meta-analysis of the duration of mechanical ventilation, length of ICU stay and length of hospital stay showed no significant differences. Conclusion: This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations. |
| Databáze: | OpenAIRE |
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