A Systematic Review and Meta-Analysis of del Nido Versus Conventional Cardioplegia in Adult Cardiac Surgery

A Systematic Review and Meta-Analysis of del Nido Versus Conventional Cardioplegia in Adult Cardiac Surgery

Del Nido cardioplegia (DC) has been used extensively in pediatric cardiac surgery but the efficacy and safety in adults remains uncertain. Our objective was to perform a systematic review and meta-analysis comparing DC and blood cardioplegia (BC) in our primary endpoint of 30-day or in-hospital mortality as well as other efficacy and safety endpoints.

Both MEDLINE and EMBASE were searched from 1996 to 2017 for studies comparing DC and BC. Data were extracted by 2 independent investigators and aggregated in a random effects model.

One randomized controlled trial (n = 89), 7 adjusted (n = 1,104), and 5 unadjusted observational studies (n = 717) were included. There was no difference in in-hospital mortality between DC and BC (relative risk:0.67, 95% confidence interval [CI]: 0.22, 2.07; P = 0.49). DC reduced cardioplegia volume requirements (mean difference [MD]:−1.1 L, 95% CI, −1.6, −0.6; P < 0.0001), aortic cross-clamp time (MD: −8 minutes, 95% CI, −12, −3; P = 0.0004), and cardiopulmonary bypass (CPB) times (MD: −8 minutes, 95% CI, −14, −3; P = 0.03). DC reduced troponin release (standardized MD: −0.3, 95% CI, −0.5, −0.1; P = 0.001). In-hospital outcomes of stroke, atrial fibrillation, acute kidney injury/dialysis, low cardiac output state, blood transfusion, reoperation rate, postoperative left ventricular EF, intensive care unit length of stay (LOS), and in-hospital LOS were comparable between groups.

DC is a safe alternative to BC in routine adult cardiac surgery. Its use is associated with reduction in CPB and aortic cross-clamp times and may potentially offer improved myocardial protection.

Recent Stories
FREE: The Case for the Anesthesiologist-Informaticist.

FREE: Robotic Cardiac Surgery in Europe: Status 2020.

FREE: Efficacy of Prothrombin Complex Concentrate (PCC) versus Fresh Frozen Plasma (FFP) in Reducing Perioperative Blood Loss in Cardiac Surgery: Study Protocol for A Non-Inferiority, Randomised Controlled Trial.

AmSECT Membership Eligibility

An Active Member shall be any perfusionist active in the practice of extracorporeal circulation technology. There are also opportunities to become a Transitional Active Member for those less than a year removed from graduation from an approved accredited training program. Other options include; an Associate Membership, International Membership, Perioperative Blood Management Clinician Membership, and Student Membership.

Click Here to Learn More

Looking for Employment Opportunities?

AmSECT members may post an available position for a perfusion specialty at your institution or firm.

Non-members may also post positions free of charge, to be reviewed by National Headquarters prior to posting.

Members - Click to Post a Position
Non-Members - Click to Post a Position

Contact AmSECT

AmSECT National Headquarters
330 N Wabash Ave, Suite 2000
Chicago, IL 60611

  Phone: (312) 321-5156
  Fax: (312) 673-6656
  Email: amsect@amsect.org

AmSECT © 2022 | View Privacy Policy | Site Map