Key result
Colchicine and indomethacin administered as primary prophylactic agents reduced the risk of post-pericardiotomy syndrome and pleural effusion after cardiac surgery, whereas dexamethasone showed no significant benefit.
Why the study?
Post-pericardiotomy syndrome is a common complication of cardiac surgery, prompting a systematic review of the efficacy of colchicine, indomethacin, and dexamethasone for its treatment and prophylaxis.
Does colchicine, dexamethasone, or indomethacin reduce the onset of post-pericardiotomy syndrome or pleural effusion in patients undergoing heart surgery?
Systematic Review (n=1,677)
Does colchicine, dexamethasone, or indomethacin reduce the onset of post-pericardiotomy syndrome or pleural effusion in patients undergoing heart surgery?
Colchicine and indomethacin may be effective as primary prophylactic agents in preventing post-pericardiotomy syndrome and pleural effusion after cardiac surgery.
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.
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Giacinto et al. (2021) conducted a systematic review in Post-pericardiotomy syndrome and pleural effusion (n=1,677). Colchicine, indomethacin, and dexamethasone vs. Placebo was evaluated on Efficacy in the treatment and prevention of post-pericardiotomy syndrome (PPS) and pleural effusion (PE). Colchicine and indomethacin administered as primary prophylactic agents reduced the risk of post-pericardiotomy syndrome and pleural effusion after cardiac surgery, whereas dexamethasone showed no significant benefit.
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