@Article{chd.12674,
AUTHOR = {Xin Li MMed, Chengxin Zhang, Di Dai MMed, Haiyuan Liu, Shenglin Ge},
TITLE = {Efficacy of dexmedetomidine in prevention of junctional ectopic tachycardia and acute kidney injury after pediatric cardiac surgery: A meta‐analysis},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {5},
PAGES = {799--807},
URL = {http://www.techscience.com/schd/v13n5/39063},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> We conducted a meta‐analysis to evaluate the effects of prophylactic
perioperative dexmedetomidine administration on postoperative junctional ectopic
tachycardia (JET) and acute kidney injury (AKI) in pediatric patients having under‐
gone cardiac surgery.<br/>
<b>Design:</b> This systematic review was registered with PROSPERO (CRD42017083880).
Databases including PubMed, Cochrane Central Register of Controlled Trials, and
Web of Science were searched for randomized controlled trials (RCTs) and observa‐
tional cohort studies from its inception to March 2018. Two reviewers independently
screened literature, extracted data, and assessed the quality of included studies using
the Jadad scale and Newcastle‐Ottawa score. Meta‐analysis was then conducted by
RevMan 5.3 and Stata 12.0 software. P value < .05 was considered significant.<br/>
<b>Results:</b> A total of nine eligible studies (5 RCTs and 4 observational studies) compris‐
ing 1851 patients were selected for the final analysis. The results of meta‐analysis
showed that dexmedetomidine significantly reduced the incidence of postoperative
JET (OR =0.35, 95% CI: 0.22 to 0.53, P < .00001), but there was no significant differ‐
ence between groups in AKI (OR =0.44, 95% CI: 0.19 to 1.04, P = .06) and all‐cause
mortality (OR =0.87, 95% CI: 0.35 to 2.14, P = .77).<br/>
<b>Conclusions:</b> The administration of perioperative dexmedetomidine effectively pre‐
vents JET in pediatric patients undergoing cardiac surgery but has no significant ef‐
fect on postoperative renal function. However, the quality of evidence for these
findings is low; thus, future larger scale randomized studies are needed to verify the
real clinical effects of dexmedetomidine prophylaxis in pediatric patients.},
DOI = {10.1111/chd.12674}
}