Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis

Abstract

Objective To compare the efficacy of Del Nido cardioplegia solution and conventional cardioplegia in adult patients. Methods Systematic searches were performed to identify related studies using PubMed, EMbase, Cochrane Library, International Clinical Trials Registry Platform (ICTRP), Chinese Biomedical Databases (CBM), China National Knowledge Infrastructure Database (CNKI), Wanfan Database and China Science and Technology Periodical Database (VIP). After testing for heterogeneity of all the eligible studies, a total of 10 studies were included. Results Cardiopulmonary bypass and cross-clamp time were significantly shorter in the Del Nido group than conventional cardioplegia group [mean difference (MD):-7.32, 95% CI:-13.72~-0.92, P=0.03; MD:-5.63, 95%CI: -9.70~-1.55, P=0.007]. During the operation, cardioplegia volume and blood glucose level were lower in the Del Nido group (MD: -555.34, 95%CI: -784.02~-326.65, P < 0.000 01; MD: -61.17, 95%CI: -78.43~-43.91, P < 0.000 01). The patients of the Del Nido group had significantly shorter length of intensive care unit stay than those of the other group (MD: -0.50, 95%CI: -0.85~-0.15, P < 0.005). There were no statistical differences in myocardial enzymes, postoperative inotropic support, ventilation time, atrial fibrillation, hospital, and mortality between the 2 groups. Conclusion Del Nido cardioplegia solution is superior to the conventional one in shortening the cardiopulmonary bypass time and block the aorta time, but yielding similar short-term clinical outcomes for adult cardiac surgery.

Keywords

• myocardial protection
• del nido cardioplegia solution
• meta-analysis