Purpose

Post-pericardiotomy syndrome (PPS) is a common complication of cardiac surgery. This systematic review aimed to investigate the efficacy of colchicine, indomethacin, and dexamethasone in the treatment and prophylaxis of PPS.

Methods

Literature research was carried out using PubMed. Studies investigating ≥ 10 patients with clinically PPS treated with colchicine, dexamethasone, and indomethacin and compared with placebo were included. Animal or in vitro experiments, studies on < 10 patients, case reports, congress reports, and review articles were excluded. Cochrane risk-of-bias tool for randomized trials (RoB2) was used for the quality assessment of studies.

Results

Seven studies were included. Among studies with postoperative colchicine treatment, two of them demonstrated a significant reduction of PPS. In the single pre-surgery colchicine administration study, a decrease of PPS cases was registered. Indomethacin pre-surgery administration was linked to a reduction of PPS. No significant result emerged with preoperative dexamethasone intake.

Conclusion

Better outcomes have been registered when colchicine and indomethacin were administered as primary prophylactic agents in preventing PPS and PE. Further RCT studies are needed to confirm these results.

中文翻译：

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心脏手术患者心包切开术后综合征的治疗和预防：系统评价

目的

心包切开术后综合征（PPS）是心脏手术的常见并发症。本系统评价旨在探讨秋水仙碱、吲哚美辛和地塞米松治疗和预防 PPS 的疗效。

方法

使用 PubMed 进行文献研究。研究纳入了 10 名以上临床 PPS 患者接受秋水仙碱、地塞米松和吲哚美辛治疗并与安慰剂进行比较的研究。动物或体外实验、<10 名患者的研究、病例报告、大会报告和评论文章被排除在外。Cochrane 随机试验偏倚风险工具 (RoB2) 用于研究质量评估。

结果

其中包括七项研究。在术后秋水仙碱治疗的研究中，其中两项显示 PPS 显着降低。在单次术前秋水仙碱给药研究中，PPS 病例有所减少。术前给予吲哚美辛与 PPS 降低有关。术前摄入地塞米松没有产生显着结果。

结论

当秋水仙碱和吲哚美辛作为预防 PPS 和 PE 的主要预防药物时，已经取得了更好的结果。需要进一步的随机对照试验研究来证实这些结果。