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dc.contributor.authorOllila, Aino
dc.contributor.authorVikatmaa, Leena
dc.contributor.authorSund, Reijo
dc.contributor.authorPettilä, Ville
dc.contributor.authorWilkman, Erika
dc.date.accessioned2019-01-24T12:02:12Z
dc.date.available2019-01-24T12:02:12Z
dc.date.issued2018
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/7386
dc.description.abstractHaemodynamic instability predisposes patients to cardiac complications in non-cardiac surgery. Esmolol, a short-acting cardioselective beta-adrenergic blocker might be efficient in perioperative cardiac protection, but could affect other vital organs, such as the kidneys, and post-discharge survival. We performed a systematic review on the use of esmolol for perioperative cardiac protection. We searched PubMed, Ovid Medline and Cochrane Central Register for Controlled trials. Eligible randomized controlled studies (RCTs) reported a perioperative esmolol intervention with at least one of the primary (major cardiac or renal complications during the first 30 postoperative days) or secondary (postoperative adverse effects and all-cause mortality) outcomes. We included 196 adult patients from three RCTs. Esmolol significantly reduced postoperative myocardial ischaemia, RR =0.43 [95% confidence interval, CI: 0.21–0.88], p = .02. No association with clinically significant bradycardia and hypotension compared to patients receiving control treatment could be confirmed (RR =7.4 [95% CI: 0.29–139.81], p = .18 and RR =2.21 [95% CI: 0.34–14.36], p = .41, respectively). No differences regarding other outcomes were observed. No study reported postoperative renal outcomes. Esmolol seems promising for the prevention of perioperative myocardial ischaemia. However, the association with bradycardia and hypotension remains unclear. Randomized trials investigating the effect of β1-selective blockade on clinically relevant outcomes and non-cardiac vital organs are warranted.
dc.language.isoenglanti
dc.publisherInforma UK Limited
dc.relation.ispartofseriesAnnals of Medicine
dc.relation.urihttp://dx.doi.org/10.1080/07853890.2018.1538565
dc.rightsAll rights reserved
dc.subjectesmolol
dc.subjectbeta blockers
dc.subjectbeta-1 selective blockers
dc.subjectmyocardial ischaemia
dc.subjectacute kidney injury
dc.subjectprevention
dc.subjectperioperative care
dc.subjectnon-cardiac surgery
dc.titleEfficacy and safety of intravenous esmolol for cardiac protection in non-cardiac surgery. A systematic review and meta-analysis
dc.description.versionfinal draft
dc.contributor.departmentSchool of Medicine / Clinical Medicine
uef.solecris.id58056256en
dc.type.publicationTieteelliset aikakauslehtiartikkelit
dc.rights.accessrights© Informa UK Limited, trading as Taylor & Francis Group
dc.relation.doi10.1080/07853890.2018.1538565
dc.description.reviewstatuspeerReviewed
dc.format.pagerange17-27
dc.publisher.countryBritannia
dc.relation.issn0785-3890
dc.relation.issue1
dc.relation.volume51
dc.rights.accesslevelopenAccess
dc.type.okmA2
uef.solecris.openaccessEi


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