The aim of this study is to evaluate the efficacy and safety of sugammadex for reversing neuromuscular blockade in pediatric patients. MEDLINE and other three Databases were searched. Randomized clinical trials were included if they compared sugammadex with neostigmine or placebo in pediatric patients undergoing surgery involving the use of rocuronium or vecuronium. The primary outcome was the time interval from administration of reversal agents to train-of-four ratio (TOFr, T4/T1) > 0.9. Incidences of any drug-related adverse events were secondary outcomes. Trial inclusion, data extraction, and risk of bias assessment were performed independently. Mean difference and relative risk were used as summary statistics with random effects models. Statistical heterogeneity was assessed by the I2 statistic. Funnel plot was used to detect publication bias. Ten studies with 580 participants were included. Although considerable heterogeneity (I2 = 98.5%) was detected in primary outcome, the results suggested that, compared with placebo or neostigmine, sugammadex can reverse rocuronium-induced neuromuscular blockade more rapidly with lower incidence of bradycardia. No significant differences were found in the incidences of other adverse events. Compared with neostigmine or placebo, sugammadex may reverse rocuronium-induced neuromuscular blockade in pediatric patients rapidly and safely.
Background Mortality and complications remain high after Acute Type A Aortic Dissection (ATAAD) open surgery, which is associated with coagulation dysfunction. Platelets play an important role in the process of coagulation. This study was to explore the relationship between postoperative platelet counts and postoperative mortality in patients with ATAAD after open aortic repair surgery.Methods Patients with ATAAD who underwent Total Arch Replacement and Frozen Elephant Trunk in Fuwai Hospital from 2011 to 2015 were selected in this study. The perioperative data were collected and sorted through the electronic clinical case system. Multivariate Logistic regression was used to analyze the risk factors for death within three years after surgery.Results A total of 495 patients were included in the analysis. After correction with the confounding factors, postoperative platelets count remained as an independent factor that was associated with lower mortality (OR = 0.918, 95%CI 0.853-0.988, P = 0.023).Conclusions The study indicated that decreased postoperative platelet count may lead to increased mortality, in patients with ATAAD underwent open aortic repair surgery.
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