Microplegia in cardiac surgery: Systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#acute-kidney-injury #cardiac-output-low #cardiac-surgical-procedures #cardioplegic-solutions #cardiopulmonary-bypass

Microplegia in cardiac surgery: Systematic review and meta-analysis

Owen et al., 2020 | J Card Surg | Meta Analysis

Citation

Owen Claire M, Asopa Sanjay, ... King Nicola. Microplegia in cardiac surgery: Systematic review and meta-analysis. J Card Surg. 2020-Oct;35(10):2737-2746. doi:10.1111/jocs.14895

Abstract

BACKGROUND: Consensus on the optimum choice of cardioplegia remains elusive. One possibility that has been suggested to have beneficial properties is microplegia, a cardioplegia of reduced crystalloid volume. The aim of this meta-analysis is to comprehensively investigate microplegia against a range of clinical outcomes. METHODS: To identify potential studies, systematic searches were carried out in four databases (eg, Pubmed, EMBASE). The search strategy included the key concepts of "microplegia" OR "mini-cardioplegia" OR "miniplegia" AND "cardiac surgery." This was followed by a meta-analysis investigating: mortality, crystalloid volume; cardiopulmonary bypass time; cross-clamp time; intra-aortic balloon pump use; spontaneous heartbeat recovery; inotropic support; low cardiac output syndrome; myocardial infarction; acute renal failure; atrial fibrillation, reoperation for bleeding; creatine kinase myocardial band (CK-MB); intensive care unit (ICU) time and hospital stay. RESULTS: Eleven studies comprising 5798 participants were analyzed. Microplegia used a lower volume of crystalloids and led to a higher spontaneous return of heartbeat, odds ratio (OR) 4.271 (95% confidence intervals [CIs]: 1.935, 9.423; I2  = 76.57%; P < .001) and a lower requirement for inotropic support, OR: 0.665 (95% CI: 0.47, 0.941; I2  = 3.53%; P = .021). Microplegia was also associated with a lower CK-MB release, mean difference (MD) -6.448 ng/mL (95% CI: -9.386, -3.511; I2  = 0%; P < .001) and a shorter ICU stay, MD: -0.411 days (95% CI: -0.812, -0.009; I2  = 17.65%; P = .045). All other comparisons were nonsignificant. CONCLUSIONS: Microplegia has similar effects to other types of cardioplegia and is beneficial with regard to spontaneous return of heartbeat, inotropic support, ICU stay, and CK-MB release.

Key Findings

Eleven studies comprising 5798 participants were analyzed. Microplegia used a lower volume of crystalloids and led to a higher spontaneous return of heartbeat, odds ratio (OR) 4.271 (95% confidence intervals [CIs]: 1.935, 9.423; I2  = 76.57%; P < .001) and a lower requirement for inotropic support, OR: 0.665 (95% CI: 0.47, 0.941; I2  = 3.53%; P = .021). Microplegia was also associated with a lower CK-MB release, mean difference (MD) -6.448 ng/mL (95% CI: -9.386, -3.511; I2  = 0%; P < .001) and a

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 5798
Age Range See abstract
Condition See abstract

MeSH Terms

  • Acute Kidney Injury
  • Cardiac Output, Low
  • Cardiac Surgical Procedures
  • Cardioplegic Solutions
  • Cardiopulmonary Bypass
  • Creatine Kinase, MB Form
  • Heart Arrest, Induced
  • Heart Rate
  • Humans
  • Length of Stay
  • Myocardial Infarction
  • Operative Time
  • Postoperative Complications
  • Recovery of Function
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: creatine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09