Table 2.
GRADE evidence profile of EA vs control cardiac surgery with cardiopulmonary bypass
| Outcome | No. of studies | No. of patients | Quality assessment | Relative effect (95% CI) | Quality | ||||
|---|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||||
| Incidence of cardiac automatic rebeat | 7 | 306 | Seriousa | None | None | None | None | RR 1.15 (1.01, 1.31) | Moderate |
| Oxidative stress indicators (SOD) | 2 | 90 | Seriousa | Seriousb | None | None | None | SMD 0.96 (0.32, 1.61) | Low |
| Oxidative stress indicators (MDA) | 3 | 130 | Seriousa | None | None | None | None | SMD －1.62 (－2.15, －1.09) | Moderate |
| Inflammatory factor indicators (IL-2) | 2 | 50 | Seriousa | Seriousb | None | Seriousc | None | SMD 1.33 (0.19, 2.47) | Very low |
| Inflammatory factor indicators (IL-6) | 4 | 250 | None | Seriousb | None | None | None | SMD －0.69 (－1.43, 0.05) | Moderate |
| Inflammatory factor indicators (IL-10) | 4 | 180 | Seriousa | Seriousb | None | Seriousc | None | SMD 0.65 (－0.01, 1.32) | Very low |
| Inflammatory factor indicators (TNF-α) | 4 | 260 | None | Seriousb | None | None | None | SMD －1.28 (－2.37, －0.19) | Moderate |
| Myocardial injury markers (cTnI) | 5 | 243 | Seriousa | Seriousb | None | None | None | SMD －1.09 (－1.85, －0.32) | Low |
| Inotrope scores | 2 | 100 | None | None | None | None | None | SMD －0.77 (－1.22, －0.31) | High |
| Sedative drug usage | 12 | 586 | Seriousa | None | None | None | None | SMD －0.31 (－0.54, －0.09) | Moderate |
| Sedative drug usage (propofol) | 5 | 238 | Seriousa | Seriousb | None | None | None | SMD －0.28 (－0.78, 0.23) | Low |
| Sedative drug usage (midazolam) | 6 | 308 | Seriousa | None | None | None | None | SMD －0.33 (－0.57, －0.09) | Moderate |
| Sedative drug usage (etomidate) | 1 | 40 | Seriousa | None | None | Seriousc | None | SMD －0.36 (－0.99, 0.27) | Low |
| Analgesic usage | 8 | 448 | Seriousa | Seriousb | None | None | None | SMD －0.96 (－1.53, －0.38) | Low |
| Analgesic usage (fentanyl) | 4 | 228 | Seriousa | Seriousb | None | None | None | SMD －0.78 (－1.72, 0.15) | Low |
| Analgesic usage (sufentanil) | 3 | 180 | Seriousa | None | None | None | None | SMD －0.98 (－1.29, －0.67) | Moderate |
| Analgesic usage (remifentanil) | 1 | 40 | Seriousa | None | None | Seriousc | None | SMD －1.91 (－2.67, －1.15) | Low |
| Tracheal intubation time | 6 | 333 | Seriousa | Seriousb | None | None | None | SMD －0.92 (－1.40, －0.45) | Low |
| Time to get out of bed for the first time | 2 | 240 | Seriousa | Seriousb | None | Seriousc | None | SMD －6.58 (－18.70, 5.53) | Very low |
| Total days of antibiotic use | 2 | 230 | Seriousa | Seriousb | None | Seriousc | None | SMD －3.13 (－6.89, 0.63) | Very low |
| Length of ICU stay | 9 | 623 | Seriousa | Seriousb | None | None | None | SMD －1.71 (－3.06, －0.36) | Low |
| Length of hospital stay | 8 | 635 | Seriousa | Seriousb | None | Seriousc | None | SMD －0.71 (－1.56, 0.14) | Very low |
Notes: EA: electroacupuncture; GRADE: Grades of Recommendation, Assessment, Development, and Evaluation; SMD: standardized mean difference; RR: relative risk; CI: confidence interval. GRADE Working Group grades of evidence: high quality: we are very confident that the true effect lies close to that of the estimate of the effect; moderate quality: we are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect. aQuality was rated down for risk of bias due to inadequately generated randomization sequence, inadequate concealment and blinding, or selectively report of outcomes; bModerate or severe heterogeneity (> 50% heterogeneity); cThe total sample size is insufficient or the outcome is not robust.