scholarly journals Arterial duct stent versus surgical shunt for patients with duct-dependent pulmonary circulation: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongxu Li ◽  
Xu Zhou ◽  
Mengsi Li

Abstract Background Both systemic-pulmonary shunt and arterial duct stent could be the palliation of duct-dependent pulmonary circulation. We aimed to compare the safety and efficacy of the two approaches. Methods The PubMed, EMBASE, and Cochrane Library databases were searched through December 2019 for studies comparing stent implantation and surgical shunt in duct-dependent pulmonary circulation. The baseline characteristics included ventricle physiology and cardiac anomaly. The main outcomes were hospital stay and total mortality. Additional outcomes included procedural complications, intensive care unit (ICU) stay, pulmonary artery growth at follow-up, and other indexes. A random- or fixed-effects model was used to summarize the estimates of the mean difference (MD)/risk ratio (RR) with 95% confidence intervals (CIs). Results In total, 757 patients with duct-dependent pulmonary circulation from six studies were included. Pooled estimates of hospital stay (MD, − 4.83; 95% CI − 7.92 to − 1.74; p < 0.05), total mortality (RR 0.44; 95% CI 0.28–0.70; p < 0.05), complications (RR 0.49; 95% CI 0.30–0.81; p < 0.05) and ICU stay (MD, − 4.00; 95% CI − 5.96 to − 2.04; p < 0.05) favored the stent group. Significant differences were found in the proportions of patients with a single ventricle (RR 0.82; 95% CI 0.68–0.98; p < 0.05) or a double ventricle (RR 1.23; 95% CI 1.07–1.41; p < 0.05) between the stent and shunt groups. Additionally, pulmonary artery growth showed no significant differences between the two groups. Conclusion Arterial duct stent appears to have not inferior outcomes of procedural complications, mortality, hospital and ICU stay, and pulmonary artery growth in selected patients compared with a surgical shunt. Trial registration CRD42019147672.

2010 ◽  
Vol 11 (11) ◽  
pp. 852-857 ◽  
Author(s):  
Giuseppe Santoro ◽  
Gianpiero Gaio ◽  
Maria Teresa Palladino ◽  
Biagio Castaldi ◽  
Carola Iacono ◽  
...  

2009 ◽  
Vol 74 (7) ◽  
pp. 1072-1076 ◽  
Author(s):  
Giuseppe Santoro ◽  
Maria Teresa Palladino ◽  
Giovanbattista Capozzi ◽  
Carola Iacono ◽  
Maria Giovanna Russo ◽  
...  

Heart ◽  
2016 ◽  
Vol 102 (6) ◽  
pp. 459-464 ◽  
Author(s):  
Giuseppe Santoro ◽  
Giovanbattista Capozzi ◽  
Cristina Capogrosso ◽  
Heba Talat Mahmoud ◽  
Gianpiero Gaio ◽  
...  

2020 ◽  
pp. 1-12
Author(s):  
Benjian Gao ◽  
Jia Luo ◽  
Ying Liu ◽  
Furui Zhong ◽  
Xiaoli Yang ◽  
...  

<b><i>Background:</i></b> The effect of immunonutrition in patients undergoing hepatectomy remains unclear. This meta-analysis aimed to assess the impact of immunonutrition on postoperative clinical outcomes in patients undergoing hepatectomy. <b><i>Methods:</i></b> A literature search of PubMed, Cochrane Library, Web of Science, and Embase databases was performed to identify all randomized controlled trials (RCTs) exploring the effect of perioperative immunonutrition in patients undergoing hepatectomy until the end of March 10, 2020. Quality assessment and data extraction of RCTs were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. <b><i>Results:</i></b> Nine RCTs involving a total of 966 patients were finally included. This meta-analysis showed that immunonutrition significantly reduced the incidences of overall postoperative complications (OR = 0.57, 95% CI: 0.34–0.95; <i>p</i> = 0.03), overall postoperative infectious complications (OR = 0.53, 95% CI: 0.37–0.75; <i>p</i> = 0.0003), and incision infection (OR = 0.50, 95% CI: 0.28–0.89; <i>p</i> = 0.02), and it shortened the length of hospital stay (MD = −3.80, 95% CI: −6.59 to −1.02; <i>p</i> = 0.007). There were no significant differences in the incidences of pulmonary infection (OR = 0.60, 95% CI: 0.32–1.12; <i>p</i> = 0.11), urinary tract infection (OR = 1.30, 95% CI: 0.55–3.08; <i>p</i> = 0.55), liver failure (OR = 0.54, 95% CI: 0.23–1.24; <i>p</i> = 0.15), and postoperative mortality (OR = 0.69, 95% CI: 0.26–1.83; <i>p</i> = 0.46). <b><i>Conclusion:</i></b> Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.


2010 ◽  
Vol 6 (3) ◽  
pp. 183-191
Author(s):  
Giuseppe Santoro ◽  
Biagio Castaldi ◽  
Gianpiero Gaio ◽  
Maria Teresa Palladino ◽  
Carola Iacono ◽  
...  

2012 ◽  
Vol 69 (11) ◽  
pp. 1881-1893 ◽  
Author(s):  
Verena M. Trenkel ◽  
Mark V. Bravington ◽  
Pascal Lorance

Catch curves are widely used to estimate total mortality for exploited marine populations. The usual population dynamics model assumes constant recruitment across years and constant total mortality. We extend this to include annual recruitment and annual total mortality. Recruitment is treated as an uncorrelated random effect, while total mortality is modelled by a random walk. Data requirements are minimal as only proportions-at-age and total catches are needed. We obtain the effective sample size for aggregated proportion-at-age data based on fitting Dirichlet-multinomial distributions to the raw sampling data. Parameter estimation is carried out by approximate likelihood. We use simulations to study parameter estimability and estimation bias of four model versions, including models treating mortality as fixed effects and misspecified models. All model versions were, in general, estimable, though for certain parameter values or replicate runs they were not. Relative estimation bias of final year total mortalities and depletion rates were lower for the proposed random effects model compared with the fixed effects version for total mortality. The model is demonstrated for the case of blue ling (Molva dypterygia) to the west of the British Isles for the period 1988 to 2011.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yanli Liu ◽  
Yilong Pan ◽  
Yuyao Yin ◽  
Wenhao Chen ◽  
Xiaodong Li

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.


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