Influences of remote ischemic preconditioning on postoperative delirium and cognitive dysfunction in adults after cardiac surgery: a meta-analysis of randomized controlled trials

Perioperative Medicine

Bai Gao¹  Yuchen Jing²  Xi Li² 

[1] Department of Neurology, Shengjing Hospital Affiliated to China Medical University, 110004, Shenyang, China;Department of Vascular Surgery, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, 110001, Shenyang, China;

关键词: Remote ischemic preconditioning;    Postoperative delirium;    Postoperative cognitive dysfunction;    Cardiac surgery;    Meta-analysis;   

DOI  :  10.1186/s13741-021-00216-1

来源: Springer

【 摘 要 】

BackgroundRemote ischemic preconditioning (RIPC) has been suggested to confer neuroprotective effect. However, influences of RIPC on postoperative delirium (POD) and cognitive dysfunction (POCD) in adults after cardiac surgery are less known. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of RIPC on POD and POCD.MethodsRelevant studies were obtained by search of PubMed, Embase, and Cochrane’s Library databases. A random-effect model was used to pool the results.ResultsTen RCTs including 2303 adults who received cardiac surgery were included. Pooled results showed that RIPC did not significantly affect the incidence of POD (six RCTs, odds ratio [OR] 1.07, 95% confidence interval [CI] 0.81 to 1.40, P = 0.65) with no significant heterogeneity (I2 = 0%). In addition, combined results showed that RIPC did not significantly reduce the incidence of POCD either (six RCTs, OR 0.64, 95% CI 0.37 to 1.11, P = 0.11) with moderate heterogeneity (I2 = 44%). Sensitivity analysis by excluding one RCT at a time showed consistent results (P values all > 0.05).ConclusionsCurrent evidence from RCTs did not support that RIPC could prevent the incidence of POD or POCD in adults after cardiac surgery. Although these findings may be validated in large-scale RCTs, particularly for the results of POCD, based on these findings, RIPC should not be routinely used as a preventative measure for POD and POCD in adult patients after cardiac surgery.

【 授权许可】

CC BY