Article description

Summary:

• This meta-analysis aimed to assess the effects of intravenous dexmedetomidine on neurological and inflammatory biomarkers in pediatric patients undergoing cardiac surgery;
• Meta-analysis of randomized controlled trials (RCT);
• The study included 7 randomized controlled trials with a study population sample size of 579 patients; 5 low, 1 uncertain, and 1 high risk of bias;
• Pooled analyses from 5 treatment groups across 3 RCTs involving 260 children demonstrated that dexmedetomidine use was associated with decreased serum levels of neuron-specific enolase (pooled SMD: 0.54; 95% CI: 0.96 to 0.12) and S-100b protein (pooled SMD: 0.85; 95% CI: 1.67 to 0.04) within 24 hours postoperatively;
• Dexmedetomidine administration was associated with a reduction in interleukin-6 levels (pooled SMD: 1.55; 95% CI: 2.82 to 0.27), based on 4 treatment groups across 2 RCT involving 190 children;
• No significant differences were observed in TNF-? levels (pooled SMD: –0.07; 95% CI: –0.33 to 0.19; 4 treatment groups in 2 RCTs with 190 children) or NF-?B levels (pooled SMD: –0.27; 95% CI: –0.62 to 0.09; 2 treatment groups in 1 RCT with 90 children) between the dexmedetomidine and control groups

Conclusions:

• The author’s findings may support the potential effects of dexmedetomidine on neurological and select inflammatory markers in children undergoing congenital heart surgery;
• Larger studies are needed to confirm the findings and determine the long-term effects of dexmedetomidine on cognitive function in children.