Meta analysis of benefits and risks between normothermia and hypothermia in cardiopulmonary bypass in adult

Xiong Yao-yao; Sun Yan-hua; Wu Si-jie; Ji Bing-yang

doi:10.13498/j.cnki.chin.j.ecc.2015.04.04

Abstract：Objective The controversy over the benefits between normothermia and hypothermia in cardiopulmonary bypass ( CPB) is still uncertain. The purpose of this systematic review and meta-analysis is to investigate the benefits and risks of normother?mia compared with hypothermia in patients who underwent CPB in randomized controlled trials ( RCTs). Methods We searched Pubmed, Embase, and the Cochrane Central Register of Controlled Trialsup to September 28, 2013 for studies reported in English. Eli?gible studies were those in which investigators enrolled adult patients who had cardiac surgery and randomised them to normothermic or hypothermic CPB. We prespecified the use of random-effects models to calculate risk ratios ( RR) and 95% CIs for binary variables, weighted mean difference ( WMD) or standard mean difference ( SMD) and 95% CIs for continuous variables. We assessed heterogene?ity using I2 . When heterogeneity was absent ( I2=0%) , we used fixed-effects models. The primary outcome was all-cause mortality and cerebrovascular accident ( CVA) in patients who had cardiac surgery in normothermic CPB compared with those in hypothermic CPB. Results The initial search strategy identified 3910 citations, of which 27 trials were eligible. These 27 trials included 9298 par?ticipants. Individuals allocated to normothermic CPB had lower all-cause mortality than those allocated to hypothermic CPB ( RR 0.66, 95% CI 0.49–0.90;P =0.009;I2=0%;7965 patients, 19 trials) . But individuals allocated to normothermic CPB had higher CVA than those allocated to hypothermic CPB ( RR 1.83, 95% CI 1.21-2.77;P=0.004;I2=0%;4182 patients,12 trails) . Conclusion Patients in normothermic CPB has lower mortality but higher CVA compared with those in hypothermic CPB.