Effects of Dexmedetomidine on Acute Kidney Injury and Perioperative Outcomes in Aortic Vascular Surgery: A Systematic Review and Meta-Analysis.

Background

Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, may help mitigate postoperative complications in patients undergoing aortic vascular surgery. Methodology: A comprehensive search was conducted across PubMed, the Cochrane Library, and Embase to identify studies assessing the efficacy and safety of dexmedetomidine compared with placebo in patients undergoing aortic vascular surgery. A random effects meta-analysis was performed with R version 4.4.1 using the "meta" package.

Results

Our analysis included eleven studies, comprising eight RCTs and three cohort studies, with a combined total of 1731 patients. The results showed that dexmedetomidine significantly reduced acute kidney injury (OR 0.49, 95% CI 0.25 to 0.98), ICU length of stay (MD -0.25 days, 95% CI -0.47 to -0.02), postoperative pulmonary complications (OR 0.55, 95% CI 0.32 to 0.94), and CRP levels 24 h post-surgery (MD -24.73 mg/L, 95% CI -46.29 to -3.16) compared to the control group. The length of hospital stay (MD -0.87 days, 95% CI -2.57 to 1.01), postoperative delirium (OR 0.78, 95% CI 0.43 to 1.42), and in-hospital mortality (OR 0.57, 95% CI 0.29 to 1.12) were not significantly different between the two groups.

Conclusion

In patients undergoing aortic vascular surgery, dexmedetomidine administration is associated with reduced acute kidney injury, length of ICU stay, postoperative pulmonary complications, and CRP levels 24 h post-surgery.