Effect of Dexmedetomidine on The Neuroglobin Expression in Elderly Patients With Minimally Invasive Coronary Artery Bypass Graft Surgery

Gao, Yan; Hai-yan, YU; Wang, Wenlong; Wang, Yeming; Teng, Jinliang; Li, Fulong

doi:10.1532/hsf.4073

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Most of the trials did not report on our outcomes. A total of 106 RCTs and one sub‐study of an included RCT provided data for quantitative synthesis 43–149 . Six of the included trials reported a total of 15 eligible comparisons 60,62,82,124,145,147 .…”

Section: Resultsmentioning

confidence: 99%

Dexmedetomidine for the prevention of delirium in adults admitted to the intensive care unit or post‐operative care unit: A systematic review of randomised clinical trials with meta‐analysis and Trial Sequential Analysis

Maagaard

Barbateskovic

Andersen-Ranberg

et al. 2023

Acta Anaesthesiol Scand

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Objectives: To assess any benefit or harm, we conducted a systematic review of randomised clinical trials (RCTs) allocating adults to dexmedetomidine versus placebo/no intervention for the prevention of delirium in intensive care or post-operative care units.Data Sources: We searched Medline, Embase, CENTRAL and other databases. The last search was 9 April 2022.Data Extraction: Literature screening, data extraction and risk of bias volume 2 assessments were performed independently and in duplicate. Primary outcomes were occurrences of serious adverse events (SAEs), delirium and all-cause mortality.We used meta-analysis, Trial Sequential Analysis, and GRADE (Grading Recommendations Assessment, Development and Evaluation).Data Synthesis: Eighty-one RCTs (15,745 patients) provided data for our primary outcomes. Results from trials at low risk of bias showed that dexmedetomidine may reduce the occurrence of the most frequently reported SAEs (relative risk[RR] 0.69; 95% CI 0.43-1.09), cumulated SAEs (RR 0.70; 95% CI 0.52-0.95) and the occurrence of delirium (RR 0.62; 95% CI 0.43-0.89). The certainty of evidence was very low for delirium. Mortality was very low in trials at low risk of bias (0.4% in the dexmedetomidine groups and 1.0% in the control groups) and meta-analysis did not

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Section: Resultsmentioning

confidence: 99%

Dexmedetomidine for the prevention of delirium in adults admitted to the intensive care unit or post‐operative care unit: A systematic review of randomised clinical trials with meta‐analysis and Trial Sequential Analysis

Maagaard

Barbateskovic

Andersen-Ranberg

et al. 2023

Acta Anaesthesiol Scand

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“…Heterogeneity: I 2 = 92%, 2 = 51.7988, p < 0.01 Ammar [30] Azeem [31] Balkanay [32] Bulow [33] Chi [34] Cho [35] Corbett [36] Cui [37] Djaiani [38] Dong [71] Elgebaly [40] Elgebaly [39] Gao [74] Goksedef [41] Huang [44] Khalil [47] Khalil [46] Kim [48] Kim [73] Li [50] Likhvantsev [51] Liu [52] Maldonado [53] Massoumi [54] Mogahd [55] Momeni [56] Park [57] Shehabi [59] Shi [retracted] Shokri [60] Soh [63] Subramaniam [64] Tosun [65] Turan [11] Wu [66] Zhai [68] Zi [70] Total . Evaluations (GRADE) organisation [13], and assessed for interstudy heterogeneity using I 2 statistics, s-squared values and p values from the chi-squared test, as well as visually inspecting forest plots [14].…”

Section: Random Effects Modelmentioning

confidence: 99%

“…Abd Aziz [28] Abdel Meguid [29] Ammar [30] Azeem [31] Balkanay [32] Bulow [33] Chi [34] Corbett [36] Cui [37] Djaiani [38] Dong [71] Elgebaly [40] Elgebaly [39] Goksedef [41] Gong [43] Herr [42] Huang [44] Karaman [45] Khalil [47] Kim [73] Leino [49] Li [50] Likhvantsev [51] Liu [52] Maldonado [53] Masoumi [72] Massoumi [54] Mogahd [55] Momeni [56] Park [57] Qin [58] Shehabi [59] Shi [retracted] Shokri [60] Shu [62] Soh [63] Tosun [65] Wu [66] Zhai [67] Zhou [69] Zi [70] Total . quality.…”

Section: Random Effects Modelmentioning

confidence: 99%

Dexmedetomidine for adult cardiac surgery: a systematic review, meta‐analysis and trial sequential analysis

et al. 2022

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The effects of dexmedetomidine in adults undergoing cardiac surgery are inconsistent. We conducted a systematic review and meta-analysis to analyse the effects of peri-operative dexmedetomidine in adults undergoing cardiac surgery. We searched MEDLINE via Pubmed, EMBASE, Scopus and Cochrane for relevant randomised controlled trials between 1 January 1990 and 1 March 2022. We used the Joanna Briggs Institute methodology checklist to assess study quality and the GRADE approach to certainty of evidence. We assessed the sensitivity of results to false data. We used random-effects meta-analyses to analyse the primary outcomes: durations of intensive care and tracheal intubation. We included 48 trials of 6273 participants. Dexmedetomidine reduced the mean (95%CI) duration of intensive care by 5.0 (2.2-7.7) h, p = 0.001, and tracheal intubation by 1.6 (0.6-2.7) h, p = 0.003. The relative risk (95%CI) for postoperative delirium was 0.58 (0.43-0.78), p = 0.001; 0.76 (0.61-0.95) for atrial fibrillation, p = 0.015; and 0.49 (0.25-0.97) for short-term mortality, p = 0.041. Bradycardia and hypotension were not significantly affected. Trial sequential analysis was consistent with the primary meta-analysis. Adjustments for possible false data reduced the mean (95%CI) reduction in duration of intensive care and tracheal intubation by dexmedetomidine to 3.6 (1.8-5.4) h and 0.8 (0.2-1.4) h, respectively. Binary adjustment for methodological quality at a Joanna Briggs Institute score threshold of 10 did not alter the results significantly. 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. The reductions in intensive care stay and tracheal intubation may or may not be considered clinically useful, particularly after adjustment for possible false data.

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“…Gao et al examined the effect of dexmedetomidine vs. control on postoperative cognitive function and neuroglobin expression following minimally invasive off-pump CABG. It should be noted that off pump CABG is prone to intra-operative oxygen desaturation and associated with POCD, given the requirement for single lung ventilation ( 182 , 183 ). The use of dexmedetomidine was associated with a lower incidence of POCD at POD7 and POD30 ( p < 0.05) and higher MMSE scores (Mean ± SD) at POD7 (24.8 ± 1.3 vs. 20.5 ± 1.4; p < 0.001) and POD30 (28.3 ± 1.5 vs. 24.2 ± 1.2; p < 0.001).…”

Section: Pathophysiology Of Postoperative Cognitive Dysfunction Follo...mentioning

confidence: 99%

“…Neuroglobin is a hypoxia inducible protein which is highly expressed in the frontal lobes and hypothalamus. It has a high affinity for oxygen, increasing oxygen delivery to the brain ( 183 , 184 ). These results suggest that neuroglobin may be neuroprotective for postoperative cognitive impairment.…”

Section: Pathophysiology Of Postoperative Cognitive Dysfunction Follo...mentioning

confidence: 99%

An Update on Postoperative Cognitive Dysfunction Following Cardiac Surgery

Smith

2022

Front. Psychiatry

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Postoperative cognitive dysfunction is extremely prevalent following cardiac surgery. The increasing patient age and comorbidity profile increases their susceptibility to cognitive impairment. The underlying pathophysiological mechanisms leading to cognitive impairment are not clearly elucidated. Using the contemporary literature (2015–present), this narrative review has three aims. Firstly, to provide an overview of postoperative cognitive impairment. Secondly, to analyse the predominant pathophysiological mechanisms leading to cognitive dysfunction following cardiac surgery such as inflammation, cerebral hypoperfusion, cerebral microemboli, glycaemic control and anaesthesia induced neurotoxicity. Lastly, to assess the current therapeutic strategies of interest to address these pathophysiological mechanisms, including the administration of dexamethasone, the prevention of prolonged cerebral desaturations and the monitoring of cerebral perfusion using near-infrared spectroscopy, surgical management strategies to reduce the neurological effects of microemboli, intraoperative glycaemic control strategies, the effect of volatile vs. intravenous anaesthesia, and the efficacy of dexmedetomidine.

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Effect of Dexmedetomidine on The Neuroglobin Expression in Elderly Patients With Minimally Invasive Coronary Artery Bypass Graft Surgery

Cited by 6 publications

References 14 publications

Dexmedetomidine for the prevention of delirium in adults admitted to the intensive care unit or post‐operative care unit: A systematic review of randomised clinical trials with meta‐analysis and Trial Sequential Analysis

Dexmedetomidine for the prevention of delirium in adults admitted to the intensive care unit or post‐operative care unit: A systematic review of randomised clinical trials with meta‐analysis and Trial Sequential Analysis

Dexmedetomidine for adult cardiac surgery: a systematic review, meta‐analysis and trial sequential analysis

An Update on Postoperative Cognitive Dysfunction Following Cardiac Surgery

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