Effects of dexmedetomidine on pulmonary function in patients receiving one-lung ventilation: a meta-analysis of randomized controlled trial

作者全名："Yang, Lin; Cai, Yongheng; Dan, Lin; Huang, He; Chen, Bing"

作者地址："[Yang, Lin; Cai, Yongheng; Dan, Lin; Huang, He; Chen, Bing] Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 2, 74 Linjianglu, Chongqing 400010, Peoples R China"

通信作者："Chen, B (通讯作者)，Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 2, 74 Linjianglu, Chongqing 400010, Peoples R China."

来源：KOREAN JOURNAL OF ANESTHESIOLOGY

ESI学科分类：　

WOS号：WOS:001158643300008

JCR分区：Q1

影响因子：4.2

年份：2023

卷号：76

期号：6

开始页：586

结束页：596

文献类型：Article

关键词：Artificial respiration; Dexmedetomidine; Meta-analysis; One-lung ventilation; Postoperative complications; Respiratory mechanics

摘要："Background: Mechanical ventilation, particularly one-lung ventilation (OLV), can cause pulmonary dysfunction. This meta-analysis assessed the effects of dexmedetomidine on the pulmonary function of patients receiving OLV. Methods: The Embase, PubMed, MEDLINE, Cochrane Library, ClinicalTrials.gov, and Chinese Clinical Trial Registry databases were systematically searched. The primary outcome was oxygenation index (OI). Other outcomes including the incidence of postoperative complications were assessed. Results: Fourteen randomized controlled trials involving 845 patients were included in this meta-analysis. Dexmedetomidine improved the OI at 30 (mean difference [MD]: 40.49, 95% CI [10.21, 70.78]), 60 (MD: 60.86, 95% CI [35.81, 85.92]), and 90 min (MD: 55, 95% CI [34.89, 75.11]) after OLV and after surgery (MD: 28.98, 95% CI [17.94, 40.0]) and improved lung compliance 90 min after OLV (MD: 3.62, 95% CI [1.7, 5.53]). Additionally, dexmedetomidine reduced the incidence of postoperative pulmonary complications (odds ratio: 0.44, 95% CI [0.24, 0.82]) and length of hospital stay (MD: -0.99, 95% CI [-1.25, -0.73]); decreased tumor necrosis factor-alpha, interleukin (IL)-6, IL-8, and malondialdehyde levels; and increased superoxide dismutase levels. However, only the results for the OI and IL-6 levels were confirmed by the sensitivity and trial sequential analyses. Conclusions: Dexmedetomidine improves oxygenation in patients receiving OLV and may additionally decrease the incidence of postoperative pulmonary complications and shorten the length of hospital stay, which may be related to associated improvements in lung compliance, anti-inflammatory effects, and regulation of oxidative stress reactions. However, robust evidence is required to confirm these conclusions."

基金机构：Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University [[2021]24]

基金资助正文：This work is supported by Grant [2021]24 from the Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University.