Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis

Abstract Objective This study aims to investigate pulmonary protective and antiinflammatory effects of dexmedetomidine (DEX) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) by meta-analysis. Methods Six databases were searched to collect trials on the pulmonary protective an...

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Main Authors: Jiapeng Liu, Ruifang Gao, Jing Ma, Jiange Han, Zhigang Guo
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03286-6
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author Jiapeng Liu
Ruifang Gao
Jing Ma
Jiange Han
Zhigang Guo
author_facet Jiapeng Liu
Ruifang Gao
Jing Ma
Jiange Han
Zhigang Guo
author_sort Jiapeng Liu
collection DOAJ
description Abstract Objective This study aims to investigate pulmonary protective and antiinflammatory effects of dexmedetomidine (DEX) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) by meta-analysis. Methods Six databases were searched to collect trials on the pulmonary protective and anti-inflammatory effects of DEX in cardiac surgery with CPB. The search period was from the establishment of each database to August 1, 2024. Alveolar arterial oxygen partial pressure difference (AaDO2), Oxygenation index (OI), respiratory index (RI), IL-6, TNF-α, and CRP values were collected in CPB progress, end of operation, postoperative 6 h(POH6), and postoperative 24 h(POH24). The control group was treated with normal saline after anesthesia induction, while the experimental group with DEX. Results A total of 9 articles were included. In the overall analysis, AaDO2 (SMD=-1.03, 95%CI:-1.62 to -0.44) and RI (SMD=-1.03, 95%CI:-1.90 to -0.16) in the DEX group were significantly lower than those in the control group, whereas OI was significantly increased (SMD = 0.44, 95%CI: 0.29–0.60). For inflammatory markers, levels of IL-6 (SMD= -1.96, 95%CI: -2.31-1.62) and TNF-α (SMD= -1.81, 95%CI: -2.36-1.26) were significantly decreased in the DEX group. Subgroup analyses based on the course of surgery presented a significant reduction in AaDO2 at the end of operation. At the end of operation, OI was significantly increased, while IL-6 and TNF-α were significantly decreased at POH6 and POH12. At POH24, no significant difference was found in CRP between the two groups (P > 0.05). Conclusion DEX has pulmonary protective and anti-inflammatory effects in patients undergoing cardiac surgery with CPB.
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spelling doaj-art-9c3892bce9d44d25bdb266b6b2474c492025-08-24T11:47:32ZengBMCBMC Anesthesiology1471-22532025-08-0125111010.1186/s12871-025-03286-6Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysisJiapeng Liu0Ruifang Gao1Jing Ma2Jiange Han3Zhigang Guo4Department of Anesthesiology, chest hospital, Tianjin UniversityDepartment of Anesthesiology, chest hospital, Tianjin UniversityTianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology BureauDepartment of Anesthesiology, chest hospital, Tianjin UniversityTianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology BureauAbstract Objective This study aims to investigate pulmonary protective and antiinflammatory effects of dexmedetomidine (DEX) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) by meta-analysis. Methods Six databases were searched to collect trials on the pulmonary protective and anti-inflammatory effects of DEX in cardiac surgery with CPB. The search period was from the establishment of each database to August 1, 2024. Alveolar arterial oxygen partial pressure difference (AaDO2), Oxygenation index (OI), respiratory index (RI), IL-6, TNF-α, and CRP values were collected in CPB progress, end of operation, postoperative 6 h(POH6), and postoperative 24 h(POH24). The control group was treated with normal saline after anesthesia induction, while the experimental group with DEX. Results A total of 9 articles were included. In the overall analysis, AaDO2 (SMD=-1.03, 95%CI:-1.62 to -0.44) and RI (SMD=-1.03, 95%CI:-1.90 to -0.16) in the DEX group were significantly lower than those in the control group, whereas OI was significantly increased (SMD = 0.44, 95%CI: 0.29–0.60). For inflammatory markers, levels of IL-6 (SMD= -1.96, 95%CI: -2.31-1.62) and TNF-α (SMD= -1.81, 95%CI: -2.36-1.26) were significantly decreased in the DEX group. Subgroup analyses based on the course of surgery presented a significant reduction in AaDO2 at the end of operation. At the end of operation, OI was significantly increased, while IL-6 and TNF-α were significantly decreased at POH6 and POH12. At POH24, no significant difference was found in CRP between the two groups (P > 0.05). Conclusion DEX has pulmonary protective and anti-inflammatory effects in patients undergoing cardiac surgery with CPB.https://doi.org/10.1186/s12871-025-03286-6DexmedetomidineCardiopulmonary bypassOxygenation indexMeta-analysis
spellingShingle Jiapeng Liu
Ruifang Gao
Jing Ma
Jiange Han
Zhigang Guo
Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
BMC Anesthesiology
Dexmedetomidine
Cardiopulmonary bypass
Oxygenation index
Meta-analysis
title Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
title_full Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
title_fullStr Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
title_full_unstemmed Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
title_short Pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass: a systematic review and metaanalysis
title_sort pulmonary protective and antiinflammatory effects of dexmedetomidine in cardiac surgery with cardiopulmonary bypass a systematic review and metaanalysis
topic Dexmedetomidine
Cardiopulmonary bypass
Oxygenation index
Meta-analysis
url https://doi.org/10.1186/s12871-025-03286-6
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