Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis

Abstract We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Comp...

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Autores principales:	Chenghui Zhou, Heerajnarain Bulluck, Nengxin Fang, Lihuan Li, Derek J. Hausenloy
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/45c2197fa0814dd3b4994e53cc97556c
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spelling	oai:doaj.org-article:45c2197fa0814dd3b4994e53cc97556c2021-12-02T12:31:46ZAge and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis10.1038/s41598-017-00308-32045-2322https://doaj.org/article/45c2197fa0814dd3b4994e53cc97556c2017-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-00308-3https://doaj.org/toc/2045-2322Abstract We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Compared with controls, RIPC significantly reduced the incidence of acute kidney injury (AKI) [odds ratio (OR) = 0.79; P = 0.02; I2 = 38%], and in particular, AKI stage I (OR = 0.65; P = 0.01; I2 = 55%). RIPC significantly shortened mechanical ventilation (MV) duration [weighted mean difference (WMD) = −0.79 hours; P = 0.002; I2 = 53%), and reduced intensive care unit (ICU) stay (WMD = −0.23 days; P = 0.07; I2 = 96%). Univariate meta-regression analyses showed that the major sources of heterogeneity for AKI stage I were age (coefficient = 0.06; P = 0.01; adjusted R2 = 0.86) and proportion of complex surgery (coefficient = 0.02; P = 0.03; adjusted R2 = 0.81). Subsequent multivariate regression and subgroup analyses also confirmed these results. The present meta-analysis suggests that RIPC reduces the incidence of AKI in adults undergoing cardiac surgery and this benefit was more pronounced in younger patients undergoing non-complex cardiac surgery. RIPC may also shorten MV duration and ICU stay. Future RCTs tailored for those most likely to benefit from RIPC warrants further investigation.Chenghui ZhouHeerajnarain BulluckNengxin FangLihuan LiDerek J. HausenloyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-11 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chenghui Zhou Heerajnarain Bulluck Nengxin Fang Lihuan Li Derek J. Hausenloy Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
description	Abstract We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Compared with controls, RIPC significantly reduced the incidence of acute kidney injury (AKI) [odds ratio (OR) = 0.79; P = 0.02; I2 = 38%], and in particular, AKI stage I (OR = 0.65; P = 0.01; I2 = 55%). RIPC significantly shortened mechanical ventilation (MV) duration [weighted mean difference (WMD) = −0.79 hours; P = 0.002; I2 = 53%), and reduced intensive care unit (ICU) stay (WMD = −0.23 days; P = 0.07; I2 = 96%). Univariate meta-regression analyses showed that the major sources of heterogeneity for AKI stage I were age (coefficient = 0.06; P = 0.01; adjusted R2 = 0.86) and proportion of complex surgery (coefficient = 0.02; P = 0.03; adjusted R2 = 0.81). Subsequent multivariate regression and subgroup analyses also confirmed these results. The present meta-analysis suggests that RIPC reduces the incidence of AKI in adults undergoing cardiac surgery and this benefit was more pronounced in younger patients undergoing non-complex cardiac surgery. RIPC may also shorten MV duration and ICU stay. Future RCTs tailored for those most likely to benefit from RIPC warrants further investigation.
format	article
author	Chenghui Zhou Heerajnarain Bulluck Nengxin Fang Lihuan Li Derek J. Hausenloy
author_facet	Chenghui Zhou Heerajnarain Bulluck Nengxin Fang Lihuan Li Derek J. Hausenloy
author_sort	Chenghui Zhou
title	Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
title_short	Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
title_full	Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
title_fullStr	Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
title_full_unstemmed	Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis
title_sort	age and surgical complexity impact on renoprotection by remote ischemic preconditioning during adult cardiac surgery: a meta analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/45c2197fa0814dd3b4994e53cc97556c
work_keys_str_mv	AT chenghuizhou ageandsurgicalcomplexityimpactonrenoprotectionbyremoteischemicpreconditioningduringadultcardiacsurgeryametaanalysis AT heerajnarainbulluck ageandsurgicalcomplexityimpactonrenoprotectionbyremoteischemicpreconditioningduringadultcardiacsurgeryametaanalysis AT nengxinfang ageandsurgicalcomplexityimpactonrenoprotectionbyremoteischemicpreconditioningduringadultcardiacsurgeryametaanalysis AT lihuanli ageandsurgicalcomplexityimpactonrenoprotectionbyremoteischemicpreconditioningduringadultcardiacsurgeryametaanalysis AT derekjhausenloy ageandsurgicalcomplexityimpactonrenoprotectionbyremoteischemicpreconditioningduringadultcardiacsurgeryametaanalysis
_version_	1718394274748301312

Age and Surgical Complexity impact on Renoprotection by Remote Ischemic Preconditioning during Adult Cardiac Surgery: A Meta analysis

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