Background: Vasoactive medications are commonly administered for afterload reduction and arterial hypertension treatment in patients after cardiac surgery. A systematic review and meta-analysis were conducted to determine the effects of sodium nitroprusside and nicardipine on hemodynamics and cardiac performance in this population.Methods: A systematic review of published manuscripts was performed to identify studies of patients who received sodium nitroprusside and nicardipine as part of the treatment for arterial hypertension or afterload reduction after cardiac surgery. A meta-analysis was then conducted to determine the effects of sodium nitroprusside and nicardipine on hemodynamics and cardiac performance. The following parameters were captured: blood pressure, heart rate, right atrial pressure, systemic vascular resistance, and stroke volume.Results: In total, five studies with 571 patients were pooled for these analyses.Systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were similar in both groups. The cardiac index was greater with nicardipine while mean pulmonary artery pressure was lower with sodium nitroprusside.Conclusion: Nicardipine and sodium nitroprusside have similar abilities in reducing afterload in the postoperative cardiac population. Statistically significant differences were found in pulmonary artery pressure and cardiac index. It may be beneficial to consider nicardipine for afterload reduction in patients with a low cardiac index. K E Y W O R D Sblood pressure, congenital heart surgery, nicardipine, sodium nitroprusside

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The present role of surgery Controversy has long surrounded the indication of surgical resection as a treatment modality for stage IIIA non-small cell lung cancer (NSCLC). Stage IIIA disease tends to be neither as clearly resectable as earlier stages of NSCLC, nor has it reached the point of distant metastasis in which resection has historically been rarely considered (1). As defined by the American Joint Committee on Cancer (AJCC) TNM staging system, IIIA NSCLC includes T3N1M0, T4N0M0, T4N1M0, T1N2M0, and T2N2M0 disease (1). The variability in treatment decision-making may result from the inclusion of a vastly heterogenous population of disease. Management of N2 disease, which is defined as ipsilateral mediastinal nodal involvement,