title: Systematic Review and Meta-Analysis of benefits and risks between normothermia and hypothermia during cardiopulmonary bypass in pediatric cardiac surgery.
abstract: BACKGROUND
  The controversy over the benefits between normothermic and hypothermic cardiopulmonary bypass (CPB) for children is still uncertain. The purpose of this systematic review and meta-analysis is to investigate the benefits and risks of normothermia comparing with hypothermia in pediatric cardiac surgery by randomized controlled trials.
  
  
  METHODS
  Pubmed, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies reported in English up to September 28, 2013. Eligible studies were those in which investigators enrolled pediatric patients, who had cardiac surgery, randomized them to normothermic or hypothermic CPB. We prespecified the use of random-effects models to calculate risk ratios and 95% CIs for binary variables, weighted mean difference (WMD) or standard mean difference and 95% CIs for continuous variables. We assessed heterogeneity using I(2). When heterogeneity was absent (I(2) = 0%), we used fixed-effects models. The endpoints were serum lactate, serum creatinine, duration of clamp, and duration of CPB in pediatrics who had cardiac surgery in normothermic CPB compared with those in hypothermic CPB.
  
  
  RESULTS
  The initial search strategy identified 3910 citations, of which 10 trials compared pediatrics and seven trails were eligible. These seven trials included 419 participants from seven countries. The serum lactate and the serum creatinine had three time points. The outcomes had no different between normothermic group and hypothermic group. Duration of clamp (WMD = -10.793, 95% CI -28.89, 7.304; P = 0.242; I(2) = 86.6%; 204 patients, three trials) and duration of CPB (WMD = -41.780, 95% CI -89.523, 5.963; P = 0.086; I(2) = 95.6%; 199 patients, three trials) also had no significant differences between two groups.
  
  
  CONCLUSIONS
  Normothermic CPB is as safe as hypothermic CPB in children requiring correction of simple congenital cardiac defects.
authors.affiliation: Department of Cardiopulmonary Bypass, Cardiovascular Institute & Fuwai Heart Hospital, PUMC & CAMS, Beijing, China; Department of Cardiopulmonary Bypass, The Second XiangYa Hospital of Central South University, ChangSha, China.
authors.forename: Yaoyao
authors.initials: Y
authors.lastname: Xiong
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Sun
authors.forename: Bingyang
authors.initials: B
authors.lastname: Ji
authors.forename: Jinping
authors.initials: J
authors.lastname: Liu
authors.forename: Guyan
authors.initials: G
authors.lastname: Wang
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
mesh_terms: D001831:Body Temperature; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002648:Child; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000379:methods*; D012306:Risk; D016896:Treatment Outcome
keywords: cardiopulmonary bypass; congenital heart disease; hypothermia; infant; meta-analysis; surgery