Evidence map›Paper›PMID 39289619›Full record

SynthesisBMC anesthesiology2024

The effect of perioperative dexmedetomidine on postoperative delirium in adult patients undergoing cardiac surgery with cardiopulmonary bypass: a systematic review and meta-analysis of randomized controlled trials.

Xiaoli Zhuang, Lin Fu, Lan Luo, Ziyuan Dong, Yu Jiang, Ju Zhao, Xiaofang Yang, Feilong Hei

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xiaoli Zhuang *Department of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Lin Fu *Department of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Lan LuoDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Ziyuan DongDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Yu JiangDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Ju ZhaoDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Xiaofang YangDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. yangxiaofang_1985@163.com.
Feilong HeiDepartment of Cardiopulmonary Bypass, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China. heifeilong@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDexmedetomidine is considered to have neuroprotective effects and may reduce postoperative delirium in both cardiac and major non-cardiac surgeries. Compared with non-cardiac surgery, the delirium incidence is extremely high after cardiac surgery, which could be caused by neuroinflammation induced by surgical stress and CPB. Thus, it is essential to explore the potential benefits of dexmedetomidine on the incidence of delirium in cardiac surgery under CPB.

methodsRandomized controlled trials studying the effect of perioperative dexmedetomidine on the delirium incidence in adult patients undergoing cardiac surgery with CPB were considered to be eligible. Data collection was conducted by two reviewers independently. The pre-specified outcome of interest is delirium incidence. RoB 2 was used to perform risk of bias assessment by two reviewers independently. The random effects model and Mantel-Haenszel statistical method were selected to pool effect sizes for each study.

resultsPubMed, Embase, Cochrane Library, and Web of Science were systematically searched from inception to June 28, 2023. Sixteen studies including 3381 participants were included in our systematic review and meta-analysis. Perioperative dexmedetomidine reduced the incidence of postoperative delirium in patients undergoing cardiac surgery with CPB compared with the other sedatives, placebo, or normal saline (RR 0.57; 95% CI 0.41-0.79; P = 0.0009; I

conclusionsPerioperative administration of dexmedetomidine could reduce the postoperative delirium occurrence in adult patients undergoing cardiac surgery with CPB. However, there is relatively significant heterogeneity among the studies. And the included studies comprise many early-stage small sample trials, which may lead to an overestimation of the beneficial effects. It is necessary to design the large-scale RCTs to further confirm the potential benefits of dexmedetomidine in cardiac surgery with CPB. REGISTRATION NUMBER: CRD42023452410.

Indexed as

Cardiac Surgical ProceduresCardiopulmonary BypassDexmedetomidineEmergence DeliriumHypnotics and SedativesAdultHumansPerioperative CareRandomized Controlled Trials as TopicDexmedetomidineHypnotics and SedativesCardiac surgeryCardiopulmonary bypassDeliriumDexmedetomidineNeurocognitive function

Identifiers

PMID39289619
PMCPMC11406813

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.