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Journal of Anesthesia
Published in: Journal of Anesthesia 6/2016

01-12-2016 | Original Article

Sevoflurane preconditioning in on-pump coronary artery bypass grafting: a meta-analysis of randomized controlled trials

Authors: Yan Lu, Liwei Wang, Na Liu, Tianxin Dong, Ruhong Li

Published in: Journal of Anesthesia | Issue 6/2016

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Abstract

Purpose

Sevoflurane preconditioning (SevoPreC) has been proved to prevent organ ischemia/reperfusion (I/R) injury in various animal models and preclinical studies. Clinical trials on cardioprotection by SevoPreC for adult patients undergoing coronary artery bypass graft (CABG) revealed mixed results. The aim of this meta-analysis was to evaluate the cardiac effect of SevoPreC in on-pump CABG.

Methods

Randomized controlled trials (RCT) comparing the cardiac effect of SevoPreC (compared with control) in adult patients undergoing CABG were searched from PubMed, Embase, and the Cochrane Library (up to November 2015). The primary endpoints were postoperative troponin levels. Additional endpoints were CK-MB levels, mechanic ventilation (MV) duration, intensive care unit (ICU) stay, and hospital length of stay (LOS).

Results

Six trials with eight comparisons enrolling a total of 384 study patients reporting postoperative troponin levels were identified. Compared with controls, SevoPreC decreased postoperative myocardial troponin levels [standardized mean difference (SMD) = −0.38; 95 % CI, −0.74 to −0.03; P = 0.04; I 2 = 63.9 %]. However, no significant differences were observed in postoperative CK-MB levels [weighted mean difference (WMD) = −1.71; P = 0.37; I 2 = 37.7 %], MV duration (WMD = −0.53; P = 0.47; I 2 = 0.0 %), ICU stay (WMD = −0.91; P = 0.39; I 2 = 0.9 %), and hospital LOS (WMD = 0.08; P = 0.86; I 2 = 8.0 %).

Conclusion

Available evidence from the present systematic review and meta-analysis suggests that sevoflurane preconditioning may reduce troponin levels in on-pump CABG. Future high-quality, large-scale clinical trials should focus on the early and long-term clinical effect of SevoPreC in on-pump CABG.
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Metadata
Title
Sevoflurane preconditioning in on-pump coronary artery bypass grafting: a meta-analysis of randomized controlled trials
Authors
Yan Lu
Liwei Wang
Na Liu
Tianxin Dong
Ruhong Li
Publication date
01-12-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 6/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2226-x

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