Cardiothoracic & vascular anesthesia
Dexmedetomidine for adult cardiac surgery: a systematic review, meta‐analysis and trial sequential analysis
Authors' conclusion
In summary, peri-operative dexmedetomidine reduced the durations of intensive care and tracheal intubation and the incidence of short-term mortality after adult cardiac surgery.
Study context
- Population
- Adults undergoing cardiac surgery
- Participants
- 6,273 adults · 48 trials
- Comparison
- Peri-operative dexmedetomidine vs control
- Outcome
- Durations of ICU stay and tracheal intubation
Methodological detailsrandom-effects meta-analysis, trial sequential analysis, GRADE certainty of evidence, false-data sensitivity analysis
- Random-effects meta-analysis
- Trial sequential analysis
- GRADE certainty of evidence
- False-data sensitivity analysis
Pooled result
As reported in the abstract
Duration of ICU stay and tracheal intubation
Mean reduction in duration of intensive care
5.0 h
95% CI 2.2–7.7P = 0.001
Dexmedetomidine
Mean reduction in duration of tracheal intubation
1.6 h
95% CI 0.6–2.7P = 0.003
Dexmedetomidine
Further pooled results
Postoperative delirium
| RR (95% CI) | P value | ||
|---|---|---|---|
| Dexmedetomidine | 0.58 (0.43–0.78) | P = 0.001 | |
| 0.512Relative risk (log scale) |
AF
| RR (95% CI) | P value | ||
|---|---|---|---|
| Dexmedetomidine | 0.76 (0.61–0.95) | P = 0.015 | |
| 0.512Relative risk (log scale) |
Short-term mortality
| RR (95% CI) | P value | ||
|---|---|---|---|
| Dexmedetomidine | 0.49 (0.25–0.97) | P = 0.041 | |
| 0.20.5125Relative risk (log scale) |
| Outcome | Estimate |
|---|---|
| ICU stay and tracheal intubation, adjusted for possible false data (sensitivity analysis)Dexmedetomidine | mean reduction in duration of intensive care 3.6 h (95% CI 1.8–5.4) |
| ICU stay and tracheal intubation, adjusted for possible false data (sensitivity analysis)Dexmedetomidine | mean reduction in duration of tracheal intubation 0.8 h (95% CI 0.2–1.4) |
Adjustment for methodological quality (JBI score threshold 10)
- Did not alter the results significantly
Safety
Bradycardia and hypotension
- Not significantly affected
Original publication
Dexmedetomidine for adult cardiac surgery: a systematic review, meta‐analysis and trial sequential analysis. Anaesthesia. Published 19 December 2022. doi:10.
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