Effect of dexmedetomidine infusion on hemodynamics and stress responses in pediatric cardiac surgery: A randomized trial

Totonchi, Ziae; Rezvani, Hengameh; Ghorbanloo, Masoud; Yazdanian, Forouzan; Mahdavi, Mohammad; Babaali, Nima; Salajegheh, Shirin; Chitsazan, Mitra

doi:10.5812/cardiovascmed.35016

Cited by 1 publication

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the measurement of IL-6, Totonchi et al . reported a lower value in the dexmedetomidine, despite not significantly (8.112±1.47 vs. 8.45±1.45) 14 . Abdelrahman et al .…”

Section: Resultsmentioning

confidence: 77%

“…Dexmedetomidine decreases the severity of the inflammatory response, in addition to its effect on indicators of myocardial injury. Five trials used IL-6 as an inflammatory marker 9 , 11 – 14 , but all six trials used other inflammatory markers as the main outcomes, resulting from different pathways producing proinflammatory markers. Dexmedetomidine was found to reduce the levels of proinflammatory cytokines, including IL-6, INF-γ, NF-κB, TNF-α, and LDH (lactate dehydrogenase) measured at various time points starting at the end of CPB to 28 h post-CPB procedure 9 , 11 – 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Five trials used IL-6 as an inflammatory marker 9 , 11 – 14 , but all six trials used other inflammatory markers as the main outcomes, resulting from different pathways producing proinflammatory markers. Dexmedetomidine was found to reduce the levels of proinflammatory cytokines, including IL-6, INF-γ, NF-κB, TNF-α, and LDH (lactate dehydrogenase) measured at various time points starting at the end of CPB to 28 h post-CPB procedure 9 , 11 – 14 . One study also reported CRP as an inflammatory marker, and the level was significantly lower in the dexmedetomidine groups 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Recent practice has shown variations in the use of dexmedetomidine for myocardial protection in pediatric cardiac surgery worldwide. The loading dose, infusion dose, and time of administration of dexmedetomidine during pediatric cardiac surgery varied among the studies 9 – 14 . Moreover, the biomarker used to determine the myocardial protective effect of dexmedetomidine in pediatric cardiac surgery was also inconsistent 9 – 14 .…”

Section: Introductionmentioning

confidence: 99%

“…The loading dose, infusion dose, and time of administration of dexmedetomidine during pediatric cardiac surgery varied among the studies 9 – 14 . Moreover, the biomarker used to determine the myocardial protective effect of dexmedetomidine in pediatric cardiac surgery was also inconsistent 9 – 14 . Thus, this phenomenon has raised the question of whether dexmedetomidine is truly suitable for myocardial protection in pediatric cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Dexmedetomidine as a myocardial protector in pediatric heart surgery using cardiopulmonary bypass: a systematic review

Kesumarini

Widyastuti²,

Boom

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Background: In recent years, dexmedetomidine has been studied as a cardioprotective agent. However, studies on its application in pediatric heart surgery using cardiopulmonary bypass (CPB) remain limited. This systematic review aimed to provide information on the cardioprotective effect of dexmedetomidine in children undergoing heart surgery using CPB. Methods: We searched several databases (MEDLINE, EMBASE, Cochrane Library, etc.) to identify all trials comparing the levels of myocardial injury via biomarkers, including pediatric patients undergoing heart surgery using CPB who received dexmedetomidine versus placebo or other anesthetic agents. Literatures from non-primary studies were excluded. Two reviewers independently screened studies for eligibility and extracted data. The Cochrane Risk of Bias tool was implemented to evaluate any potential biases. Information from eligible studies was summarized and correspondingly reviewed based on any quantitative outcomes. Results: We identified six trials composed of 419 participants, three of which (n=241) showed significantly reduced interleukin-6 (IL-6) levels in the dexmedetomidine group, while one study (n=40) showed no IL-6 difference between groups. Cardiac troponin I (cTnI) and Creatinine Kinase Myocardial Band (CKMB), as myocardial injury biomarkers, were found to be lower in two trials (n=180). Despite several limitations hindering this review to pool the data objectively, majority of published studies indicated that dexmedetomidine is a seemingly efficacious agent protecting against cardiac injury during bypass. Conclusions: These studies suggest that dexmedetomidine has cardioprotective effects through lowering of cardiac injury biomarkers, while improving its clinical outcomes after heart surgery using bypass.

show abstract

“…On the measurement of IL-6, Totonchi et al . reported a lower value in the dexmedetomidine, despite not significantly (8.112±1.47 vs. 8.45±1.45) 14 . Abdelrahman et al .…”

Section: Resultsmentioning

confidence: 77%