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Adding Blood to St Thomas Solution Does Not Improve Mortality in Pediatric Cardiac Surgery; A Meta-analysis of a Homogenous Population

Mark Awori, Nikita Mehta, Naomi Kebba, Enoch Makori

Department of Surgery, University of Nairobi, Kenya​

Correspondence to: Dr. Mark Awori, P.O Box 14677-00800, Nairobi. Email: mnawori@yahoo.com

Abstract

Background: Cardioplegia is the gold-standard for providing ideal operating conditions while effecting myocardial protection. Some studies suggest that the addition of blood to cardioplegia improves efficacy; this is generally accepted as true. However, the few meta analyses conducted on children have pooled heterogeneous populations, this raises concern about the validity of their conclusions. Method: PUBMED, the Cochrane Library and Google scholar were searched systematically until March 2019 using the search terms “cardioplegia”; “myocardial protection”; “pediatric” “paediatric”; “children”; “infants”; “neonates”. Full text articles were examined if abstracts revealed that the studies possibly contained a blood cardioplegia arm and a crystalloid cardioplegia arm. Studies were included in the meta-analysis if they had a 4:1 blood cardioplegia arm and a St Thomas solution arm. Meta-analysis was conducted using Meta-Mar. Results: The search retrieved 423 articles; 5 were included in the meta-analysis; representing 324 patients. The risk ratio for operative mortality was 0.77(95% CI 0.24-2.5; p=0.66). There was little evidence of heterogeneity of the pooled patients. Conclusion: Adding blood to St Thomas cardioplegia solution did not improve In-hospital operative mortality; this may have implications for blood cardioplegia use.

Key words: Myocardial protection/cardioplegia, Pediatric, Congenital heart surgery, Mortality

Ann Afr Surg. 2019; 17(1):***

DOI: http://dx.doi.org/10.4314/aas.v16i1.*

Conflicts of Interest: None

Funding: None

© 2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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