{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:46:03Z","timestamp":1791823563524,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Del Nido cardioplegia (DC) has been used extensively in pediatric cardiac surgery but the efficacy and safety in adults remains uncertain. Our objective was to perform a systematic review and meta-analysis comparing DC and blood cardioplegia (BC) in our primary endpoint of 30-day or in-hospital mortality as well as other efficacy and safety endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Both MEDLINE and EMBASE were searched from 1996 to 2017 for studies comparing DC and BC. Data were extracted by 2 independent investigators and aggregated in a random effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One randomized controlled trial ( n = 89), 7 adjusted ( n = 1,104), and 5 unadjusted observational studies ( n = 717) were included. There was no difference in in-hospital mortality between DC and BC (relative risk:0.67, 95% confidence interval [CI]: 0.22, 2.07; P = 0.49). DC reduced cardioplegia volume requirements (mean difference [MD]:\u22121.1 L, 95% CI, \u22121.6, \u22120.6; P &lt; 0.0001), aortic cross-clamp time (MD: \u22128 minutes, 95% CI, \u221212, \u22123; P = 0.0004), and cardiopulmonary bypass (CPB) times (MD: \u22128 minutes, 95% CI, \u221214, \u22123; P = 0.03). DC reduced troponin release (standardized MD: \u22120.3, 95% CI, \u22120.5, \u22120.1; P = 0.001). In-hospital outcomes of stroke, atrial fibrillation, acute kidney injury\/dialysis, low cardiac output state, blood transfusion, reoperation rate, postoperative left ventricular EF, intensive care unit length of stay (LOS), and in-hospital LOS were comparable between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DC is a safe alternative to BC in routine adult cardiac surgery. Its use is associated with reduction in CPB and aortic cross-clamp times and may potentially offer improved myocardial protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1556984519863718","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T06:51:56Z","timestamp":1564123916000},"page":"385-393","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["A Systematic Review and Meta-Analysis of del Nido Versus Conventional Cardioplegia in Adult Cardiac Surgery"],"prefix":"10.1177","volume":"14","author":[{"given":"Kevin R.","family":"An","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishtiaq A.","family":"Rahman","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick Y.","family":"Tam","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niv","family":"Ad","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subodh","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Fremes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Latter","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Yanagawa","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, University of Toronto, Ontario, 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