Efficacy and Safety of Human Serum Albumin in Perioperative Management of Cardiac Surgery:A Meta-Analysis
Objective To provide a reference for the rational use of human serum albumin(HSA)in clinical practice.Methods The randomized controlled trials(RCTs)of HSA in perioperative period of cardiac surgery in The Cochrane Library,PubMed,Web of Science,CNKI,WanFang,and VIP databases from the inception of the database to August 31,2023 were searched.The literature was screened and data were extracted by two researchers.The quality of the included literature was evaluated by the risk bias assessment tool recommended by Cochrane Systematic Review Manual 5.1.0.Meta-analysis,sensitivity analysis and publication bias analysis were performed by the RevMan 5.4 software.Results Nine RCTs were included,involving 2 223 patients.Meta-analysis showed that the all-cause mortality[RR=1.55,95％CI(0.62,3.86),P=0.35],hospital stay[MD=-0.40,95％CI(-0.89,0.09),P=0.11],intensive care unit(ICU)stay[MD=-0.26,95％CI(-0.66,0.13),P=0.20],duration of mechanical ventilation[MD=-0.21,95％CI(-0.91,0.49),P=0.55],red blood cell infusion rate[RR=0.96,95％CI(0.68,1.36),P=0.82],platelet infusion rate[RR=0.70,95％CI(0.42,1.17),P=0.17],plasma infusion rate[RR=0.83,95％CI(0.50,1.40),P=0.49],incidence of acute kidney injury[RR=0.98,95％CI(0.62,1.57),P=0.94]in the observation group were similar with those in the control group.The subgroup analysis showed that the bleeding volume of patients in the 4％HSA group was significantly larger than that in the control group[MD=141.55,95％CI(115.02,168.07),P＜0.000 01];the bleeding volume of patients in the 5％HSA group was similar with that in the control group[MD=20.94,95％CI(-131.80,173.68),P=0.79].The publication bias indicated that there was a high possibility of publication bias in this study.Conclusion Current evidence suggests that the use of HSA in the perioperative period of cardiac surgery does not significantly improve the long-term prognostic indicators,decrease the use of blood products and the risk of adverse reactions in patients.The volume of postoperative bleeding may vary with the use of different mass concentrations of HSA.
human serum albuminDepartment of Cardiac Surgeryperioperative periodefficacysafetyMeta-analysis
万方数据
维普
