https://scholars.lib.ntu.edu.tw/handle/123456789/636892
標題: | Comparison of inhaled nitric oxide with aerosolized prostacyclin or analogues for the postoperative management of pulmonary hypertension: a systematic review and meta-analysis | 作者: | SHIH-HONG CHEN LI-KUEI CHEN Tsung-Han Teng WEI-HAN CHOU |
關鍵字: | PAH; Pulmonary hypertension; inhaled nitric oxide; prostacyclin analogues; pulmonary arterial hypertension | 公開日期: | 2020 | 出版社: | Informa {UK} Limited | 卷: | 52 | 期: | 3-4 | 來源出版物: | Annals of Medicine | 摘要: | Background: This study aims to compare the effectiveness of inhaled prostacyclin or its analoguesversus nitric oxide (NO) in treating pulmonary hypertension (PH) after cardiac or pulmonary surgery remains unclear.Methods: PubMed, Cochrane, and Embase databases were searched for literature published prior to December 2019 using the following keywords: inhaled, nitric oxide, prostacyclin, iloprost, treprostinil, epoprostenol, Tyvaso, flolan, and pulmonary hypertension. Randomized controlled trials and multiple-armed prospective studies that evaluated inhaled NO versus prostacyclin (or analogues) in patients for perioperative and/or postoperative PH after either cardiac or pulmonary surgery were included. Retrospective studies, reviews, letters, comments, editorials, and case reports were excluded.Results: Seven studies with a total of 195 patients were included. No difference in the improvement of mean pulmonary arterial pressure (pooled difference in mean change= -0.10, 95% CI: -3.98 to 3.78, p = .959) or pulmonary vascular resistance (pooled standardized difference in mean change= -0.27, 95% CI: -0.60 to 0.05, p = .099) were found between the two treatments. Similarly, no difference was found in other outcomes between the two treatments or subgroup analysis.Conclusions: Inhaled prostacyclin (or analogues) was comparable to inhaled NO in treating PH after cardiac or pulmonary surgery.Key messagesThis study compared the efficacy of inhaled prostacyclin or its analogues versus inhaled NO to treat PH after surgery. The two types of agent exhibited similar efficacy in managing MPAP, PVR, heart rate, and cardiac output was observed.Inhaled prostacyclin may serve as an alternative treatment option for PH after cardiac or pulmonary surgery. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/636892 | ISSN: | 0785-3890 1365-2060 |
DOI: | 10.1080/07853890.2020.1746826 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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