Open Access

REVIEW

Efficacy of dexmedetomidine in prevention of junctional ectopic tachycardia and acute kidney injury after pediatric cardiac surgery: A meta‐analysis

by

Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China

* Corresponding Author: Shenglin Ge, Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Shushan District, Hefei, Anhui, China. Email:

Congenital Heart Disease 2018, 13(5), 799-807. https://doi.org/10.1111/chd.12674

Abstract

Objective: 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.
Design: 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.
Results: 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).
Conclusions: 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.

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