Document Detail

Nitric Oxide Donor Agents for the Treatment of Ischemia/Reperfusion Injury in Human Subjects: A Systematic Review.
MedLine Citation:
PMID:  23358103     Owner:  NLM     Status:  Publisher    
OBJECTIVE: In animal models, administration of nitric oxide (NO) donor agents has been shown to reduce ischemia/reperfusion (I/R) injury. Our aim was to systematically analyze the biomedical literature to determine the effects of NO-donor agent administration on I/R injury in human subjects. We hypothesized that NO-donor agents reduce I/R injury. METHODS: We performed a search of Cochrane Library, PUBMED, CINHAL, conference proceedings, and other sources with no restriction to language using a comprehensive strategy. Study inclusion criteria were: (1) human subjects; (2) documented periods of ischemia and reperfusion; (3) treatment arm comprised of NO-donor agent administration; and (4) use of a control arm. We excluded secondary reports, reviews, correspondence, and editorials. We performed a qualitative analysis to collate and summarize treatment effects according to the recommended methodology from the Cochrane Handbook. RESULTS: Twenty-six studies involving multiple etiologies of I/R injury (10 cardiopulmonary bypass, 6 organ transplant, 7 myocardial infarction, 3 limb tourniquet) met all inclusion and no exclusion criteria. Six of 26 (23%) were considered high quality studies as per the Cochrane criteria for assessing risk of bias. In 20/26 (77%) studies, and 4/6 (67%) high-quality studies, patients treated with NO-donor agents experienced reduced I/R injury compared to controls. Zero clinical studies to date have tested NO-donor agent administration in patients with cerebral I/R injury (e.g. cardiac arrest, stroke). CONCLUSION: Despite a paucity of high-quality clinical investigations, the preponderance of evidence to date suggests that administration of NO-donor agents may be an effective treatment for I/R injury in human subjects.
Brian W Roberts; Jessica Mitchell; J Hope Kilgannon; Michael E Chansky; Stephen Trzeciak
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-25
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Department of Emergency Medicine (BWR, JM, JHK, MEC, ST), and the Department of Medicine, Division of Critical Care Medicine (ST), Cooper University Hospital, Camden, New Jersey, USA. JM,; JHK,; MEC,; ST,
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