Does the use of a hot-shot lead to improved outcomes following adult cardiac surgery?

Interactive Cardiovascular and Thoracic Surgery
Sara VolpiRavi De Silva

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of a 'hot-shot' (terminal warm blood cardioplegia) lead to improved outcomes following adult cardiac surgery? Altogether, 567 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that evidence supporting the use of a hot-shot prior to weaning from cardiopulmonary bypass is rather limited. All 8 of the randomized trials to date are small studies which examine heterogeneous groups of patients, and unfortunately, the conclusions are inconsistent, perhaps in part related to the inability to demonstrate statistical significance with small group size. From the evidence, it appears likely that the use of a hot-shot results in more rapid biochemical, electrical and possibly functional myocardial recovery from cardiopulmonary bypass. However, no study has been able to demonstrate that this leads to improved clinical outcomes other than lower incidence of atrial fibrillation.

References

Jul 15, 1998·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·M CaputoG D Angelini
Mar 14, 2000·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·Y HattoriR Hoshino
Mar 23, 2006·Asian Cardiovascular & Thoracic Annals·Chareonkiat RergkliangVorapong Chowchuvech
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Joel DunningKevin Mackway-Jones
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Bingyang JiQiang Hu
Jan 29, 2008·The Annals of Thoracic Surgery·Raimondo AscioneGianni D Angelini

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