Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis

Xu XU; Weifan WANG; Min YU; Yongnan LI

doi:10.16016/j.1000-5404.202010151

您当前的位置：

首页 >

文章列表页 >

Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis

Clinical Medicine | 更新时间：2026-01-09

- Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis
- Journal of Third Military Medical University Vol. 43, Issue 8, Pages: 747-754(2021)
- 作者机构：
  
  730030 兰州，兰州大学第二医院心脏外科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202010151
  CLC： R654.1;R654.2;R944.1
- Received：22 October 2020，
  
  Revised：2021-01-12，
  
  Published：30 April 2021
- 稿件说明：
移动端阅览
Xu XU, Weifan WANG, Min YU, et al. Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis[J]. Journal of Third Military Medical University, 2021, 43(8): 747-754.
DOI：

Xu XU, Weifan WANG, Min YU, et al. Effect of Del Nido cardioplegia solution on myocardial protection in adult cardiac surgery under cardiopulmonary bypass: a Meta-analysis[J]. Journal of Third Military Medical University, 2021, 43(8): 747-754. DOI： 10.16016/j.1000-5404.202010151.

摘要

目的

比较Del Nido液和常规心脏停搏液在成人患者中的应用效果。

方法

通过对PubMed、EMbase、The Cochrane Library、国际临床试验注册平台(ICTRP)、中国生物医学文献数据库(CBM)、清华同方(CNKI)、万方和维普(VIP)数据库进行系统检索相关文献，共纳入10项研究进行系统评价。

结果

研究显示应用Del Nido液组体外循环时间和阻断时间明显短于常规心脏停搏液组(MD：-7.32，95%

：-13.72~-0.92，

=0.03；MD：-5.63，95 %

：-9.70~-1.55，

=0.007)。术中Del Nido液组停搏液灌注量和血糖水平均低于对照组(MD：-555.34，95 %

：-784.02~-326.65，

0.000 01；MD：-61.17，95%

：-78.43~-43.91，

0.000 01)。应用Del Nido液的患者，ICU停留时间显著缩短(MD：-0.50，95%

：-0.85~-0.15，

0.005)。两组在心肌酶、术后心脏支持、机械通气时间、房颤发生率、住院时间和死亡率等方面无统计学差异。

结论

在成人心脏手术中的心肌保护中，相对于常规心脏停搏液，使用Del Nido液在能明显缩短体外循环时间和阻断主动脉时间的同时，达到与其相近的短期临床效果。

Abstract

Objective

To compare the efficacy of Del Nido cardioplegia solution and conventional cardioplegia in adult patients.

Methods

Systematic searches were performed to identify related studies using PubMed

EMbase

Cochrane Library

International Clinical Trials Registry Platform (ICTRP)

Chinese Biomedical Databases (CBM)

China National Knowledge Infrastructure Database (CNKI)

Wanfan Database and China Science and Technology Periodical Database (VIP). After testing for heterogeneity of all the eligible studies

a total of 10 studies were included.

Results

Cardiopulmonary bypass and cross-clamp time were significantly shorter in the Del Nido group than conventional cardioplegia group [mean difference (MD):-7.32

95%

:-13.72~-0.92

=0.03; MD:-5.63

95%

: -9.70~-1.55

=0.007

]

. During the operation

cardioplegia volume and blood glucose level were lower in the Del Nido group (MD: -555.34

95%

: -784.02~-326.65

0.000 01; MD: -61.17

95%

: -78.43~-43.91

0.000 01). The patients of the Del Nido group had significantly shorter length of intensive care unit stay than those of the other group (MD: -0.50

95%

: -0.85~-0.15

0.005). There were no statistical differences in myocardial enzymes

postoperative inotropic support

ventilation time

atrial fibrillation

hospital

and mortality between the 2 groups.

Conclusion

Del Nido cardioplegia solution is superior to the conventional one in shortening the cardiopulmonary bypass time and block the aorta time

but yielding similar short-term clinical outcomes for adult cardiac surgery.

关键词

Keywords

references

CHAMBERS D J, FALLOUH H B. Cardioplegia and cardiac surgery: pharmacological arrest and cardioprotection during global ischemia and reperfusion[J]. Pharmacol Ther, 2010, 127(1): 41-52. DOI: 10.1016/j.pharmthera.2010.04.001.

MATTE G S, DEL NIDO P J. History and use of del Nido cardioplegia solution at Boston Children's Hospital[J]. J Extra Corpor Technol, 2012, 44(3): 98-103.

MOHER D, LIBERATI A, TETZLAFF J, et al . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement[J ] . PLoS Med, 2009, 6(7): e1000097. DOI: 10.1371/journal.pmed.1000097.

YEREBAKAN H, SORABELLA R A, NAJJAR M, et al . Del Nido Cardioplegia can be safely administered in high-risk coronary artery bypass grafting surgery after acute myocardial infarction: a propensity matched comparison[J ] . J Cardiothorac Surg, 2014, 9: 141. DOI: 10.1186/s13019-014-0141-5.

MICK S L, ROBICH M P, HOUGHTALING P L, et al . Del Nido versus Buckberg cardioplegia in adult isolated valve surgery[J ] . J Thorac Cardiovasc Surg, 2015, 149(2): 626-634;discussion634-636. DOI: 10.1016/j.jtcvs.2014.10.085.

YAMMINE M, NEELY R C, LOBERMAN D, et al . The use of lidocaine containing cardioplegia in surgery for adult acquired heart disease[J ] . J Card Surg, 2015, 30(9): 677-684. DOI: 10.1111/jocs.12597.

OTA T, YEREBAKAN H, NEELY R C, et al . Short-term outcomes in adult cardiac surgery in the use of del Nido cardioplegia solution[J ] . Perfusion, 2016, 31(1): 27-33. DOI: 10.1177/0267659115599453.

TIMEK T, WILLEKES C, HULME O, et al . Propensity matched analysis of del nido cardioplegia in adult coronary artery bypass grafting: initial experience with 100 consecutive patients[J ] . Ann Thorac Surg, 2016, 101(6): 2237-2241. DOI: 10.1016/j.athoracsur.2015.12.058.

KIM J S, JEONG J H, MOON S J, et al . Sufficient myocardial protection of del Nido cardioplegia regardless of ventricular mass and myocardial ischemic time in adult cardiac surgical patients[J ] . J Thorac Dis, 2016, 8(8): 2004-2010. DOI: 10.21037/jtd.2016.06.66.

GUAJARDO SALINAS G E, NUTT R, RODRIGUEZ-ARAUJO G. Del Nido cardioplegia in low risk adults undergoing first time coronary artery bypass surgery[J]. Perfusion, 2017, 32(1): 68-73. DOI: 10.1177/026765911-6661051.

张开天, 曹勇, 刘超, 等. Del Nido心脏停搏液在成人瓣膜置换术中的应用和疗效分析[J]. 中国体外循环杂志, 2018, 16(4): 200-205. DOI: 10.13498/j.cnki.chin.j.ecc.2018. 04.03.

ZHANG K T, CAO Y, LIU C, et al . Application and effect of Del Nido cardioplegia in adult valve replacement surgery[J ] . Chin J Extracorporeal Circulation, 2018, 16(4): 200-205. DOI: 10.13498/j.cnki.chin.j.ecc.2018. 04.03.j.ecc.2018. 04.03.

吕晓钗, 叶建熙, 刘燕. Del Nido心肌保护液在成人心脏瓣膜手术中应用的病例对照研究[J]. 中国胸心血管外科临床杂志, 2018, 25(9): 781-785.

LYU X C, YE J X, LIU Y. Application of Del Nido cardioplegia in adult valve surgery: a case control study[J]. Chin J Clin Thorac Cardiovasc Surg, 2018, 25(9): 781-785.

姜秀丽, 顾天玉, 刘麟, 等. del Nido心脏停搏液在成人冠状动脉旁路移植联合瓣膜置换手术中的安全性[J]. 中华医学杂志, 2019, 99(48): 3770-3774. DOI: 10.3760/cma.j.issn.0376-2491.2019.48.003.

JIANG X L, GU T Y, LIU L, et al . Safety of del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults[J ] . Natl Med J China, 2019, 99(48): 3770-3774. DOI: 10.3760/cma.j.issn.0376-2491.2019.48.003.cma.j.issn. 0376-2491.2019.48.003.

SHAH S, GILLILAND H, BENSON G. Agglutinins and cardiac surgery: a web based survey of cardiac anaesthetic practice; questions raised and possible solutions[J]. Heart Lung Vessel, 2014, 6(3): 187-196.

KIM W K, KIM H R, KIM J B, et al . Del Nido cardioplegia in adult cardiac surgery: beyond single-valve surgery[J ] . Interact Cardiovasc Thorac Surg, 2018, 27(1): 81-87. DOI: 10.1093/icvts/ivy028.

SØRAAS C L, FRⅡS C, ENGEBRETSEN K V, et al . Troponin T is a better predictor than creatine kinase-MB of long-term mortality after coronary artery bypass graft surgery[J ] . Am Heart J, 2012, 164(5): 779-785. DOI: 10.1016/j.ahj.2012.05.027.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis

Levels of alanine aminotransferase and aspartate aminotransferase in coronavirus disease 2019 patients: a meta-analysis

Risk factors of severe and critical coronavirus disease 2019: a meta-analysis

Efficacy and safety of transurethral laser versus transurethral resection for non-muscle invasive bladder urothelial carcinoma: a meta-analysis

Related Author

HAN Weidong

FAN Yiming

CHEN Pan

HU Nan

HU Shiqi

XIONG Te

YIN Rui

Weigao LIU

Related Institution

Department of Dermatology， First Affiliated Hospital， Army Medical University （Third Military Medical University）

ICU, Neijiang Hospital of Traditional Chinese Medicine

Center for Infection and liver Disease, the Second Affiliated Hospital of Chongqing Medical University

Department of Maternal and Child Health, Tongji Medical College, Huazhong University of Science and Technology

Center of Injury Prevention, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology

⁰