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. 2011 Dec 7;2011(12):CD009052. doi: 10.1002/14651858.CD009052.pub2

Comparison 1. Intervention versus control.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 60‐day mortality 14   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.1 Aprotinin versus control 3 280 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.18, 1.45]
1.2 Tranexamic acid versus control 3 139 Risk Ratio (M‐H, Fixed, 95% CI) 0.55 [0.17, 1.76]
1.3 Epsilon amino caproic acid (EACA) versus control 1 62 Risk Ratio (M‐H, Fixed, 95% CI) 0.71 [0.13, 3.94]
1.4 Antithrombin III versus control 1 29 Risk Ratio (M‐H, Fixed, 95% CI) 0.24 [0.01, 4.65]
1.5 Recombinant factor VIIa (rFVIIa) versus control 3 286 Risk Ratio (M‐H, Fixed, 95% CI) 1.51 [0.33, 6.95]
1.6 Aprotinin: bolus versus continuous infusion 1 23 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
1.7 Solvent detergent plasma versus standard fresh frozen plasma 1 25 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
1.8 Tranexamic acid versus EACA 1 84 Risk Ratio (M‐H, Fixed, 95% CI) 1.0 [0.21, 4.67]
1.9 Tranexamic acid versus aprotinin 2 178 Risk Ratio (M‐H, Fixed, 95% CI) 4.12 [0.71, 23.76]
2 Mortality at maximal follow‐up 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
2.1 Antithrombin III versus control 1 29 Risk Ratio (M‐H, Fixed, 95% CI) 0.25 [0.03, 1.85]
2.2 Thromboelastography versus control 1 28 Risk Ratio (M‐H, Fixed, 95% CI) 0.67 [0.13, 3.40]
3 Primary graft non‐function 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.1 Aprotinin versus control 2 217 Risk Ratio (M‐H, Fixed, 95% CI) 0.15 [0.02, 1.25]
3.2 Tranexamic acid versus control 1 32 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.13, 68.57]
3.3 Recombinant factor VIIa (rFVIIa) versus control 1 20 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
4 Retransplantation 7   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
4.1 Aprotinin versus control 2 217 Risk Ratio (M‐H, Random, 95% CI) 0.21 [0.02, 1.79]
4.2 Tranexamic acid versus control 2 77 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.18, 3.48]
4.3 Prostaglandin versus control 1 20 Risk Ratio (M‐H, Random, 95% CI) 0.0 [0.0, 0.0]
4.4 Aprotinin: bolus versus continuous infusion 1 23 Risk Ratio (M‐H, Random, 95% CI) 0.77 [0.05, 10.85]
4.5 Tranexamic acid versus aprotinin 1 127 Risk Ratio (M‐H, Random, 95% CI) 2.95 [0.12, 71.17]
5 Thromboembolic episodes 12   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
5.1 Aprotinin versus control 3 280 Risk Ratio (M‐H, Fixed, 95% CI) 0.60 [0.18, 1.96]
5.2 Tranexamic acid versus control 5 179 Risk Ratio (M‐H, Fixed, 95% CI) 2.20 [0.38, 12.64]
5.3 Epsilon amino caproic acid (EACA) versus control 1 62 Risk Ratio (M‐H, Fixed, 95% CI) 0.95 [0.09, 9.89]
5.4 Recombinant factor VIIa (rFVIIa) versus control 2 266 Risk Ratio (M‐H, Fixed, 95% CI) 1.38 [0.65, 2.91]
5.5 Tranexamic acid versus EACA 1 84 Risk Ratio (M‐H, Fixed, 95% CI) 2.0 [0.39, 10.34]
5.6 Tranexamic acid versus aprotinin 2 178 Risk Ratio (M‐H, Fixed, 95% CI) 1.97 [0.37, 10.37]
6 Serious adverse events 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
6.1 Aprotinin versus control 1 137 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.49, 2.11]
6.2 Recombinant factor VIIa (rFVIIa) versus control 2 266 Risk Ratio (M‐H, Fixed, 95% CI) 1.30 [0.94, 1.78]
6.3 Low central venous pressure versus control 1 86 Risk Ratio (M‐H, Fixed, 95% CI) 0.71 [0.55, 0.92]
7 Blood loss 11   Mean Difference (IV, Random, 95% CI) Subtotals only
7.1 Aprotinin versus control 3 195 Mean Difference (IV, Random, 95% CI) ‐1.36 [‐3.39, 0.66]
7.2 Tranexamic acid versus control 2 65 Mean Difference (IV, Random, 95% CI) ‐4.98 [‐10.18, 0.23]
7.3 Antithrombin III versus control 1 29 Mean Difference (IV, Random, 95% CI) 1.9 [‐4.86, 8.66]
7.4 Thromboelastography versus control 2 62 Mean Difference (IV, Random, 95% CI) ‐1.13 [‐1.85, ‐0.41]
7.5 Low central venous pressure versus control 1 86 Mean Difference (IV, Random, 95% CI) ‐1.19 [‐1.88, ‐0.50]
7.6 Tranexamic acid versus aprotinin 2 71 Mean Difference (IV, Random, 95% CI) ‐1.01 [‐2.31, 0.29]
8 Red‐cell or whole blood transfusion 4   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
8.1 Aprotinin versus control 1 80 Risk Ratio (M‐H, Fixed, 95% CI) 0.68 [0.40, 1.18]
8.2 Tranexamic acid versus control 1 62 Risk Ratio (M‐H, Fixed, 95% CI) 0.77 [0.60, 0.98]
8.3 Epsilon amino caproic acid (EACA) versus control 1 62 Risk Ratio (M‐H, Fixed, 95% CI) 0.90 [0.77, 1.06]
8.4 Recombinant factor VIIa (rFVIIa) versus control 1 182 Risk Ratio (M‐H, Fixed, 95% CI) 0.91 [0.86, 0.97]
8.5 Tranexamic acid versus EACA 1 84 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.64, 1.02]
8.6 Tranexamic acid versus aprotinin 1 127 Risk Ratio (M‐H, Fixed, 95% CI) 0.94 [0.71, 1.23]
9 Red cell or whole blood transfusion 29   Std. Mean Difference (IV, Fixed, 95% CI) Subtotals only
9.1 Aprotinin versus control 8 375 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.61 [‐0.82, ‐0.40]
9.2 Tranexamic acid versus control 4 159 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.27 [‐0.59, 0.06]
9.3 Epsilon amino caproic acid (EACA) versus control 1 62 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.17 [‐0.71, 0.36]
9.4 Antithrombin III versus control 1 29 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.04 [‐0.77, 0.69]
9.5 Recombinant factor VIIa (rFVIIa) versus control 2 221 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.05 [‐0.32, 0.23]
9.6 Oestrogen versus control 1 30 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.58 [‐1.32, 0.15]
9.7 Prostaglandin versus control 1 20 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.04 [‐0.92, 0.83]
9.8 Norepinephrine versus control 1 65 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.04 [‐0.53, 0.44]
9.9 Thromboelastography versus control 2 62 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.73 [‐1.25, ‐0.20]
9.10 Low central venous pressure versus control 1 86 Std. Mean Difference (IV, Fixed, 95% CI) ‐1.17 [‐1.62, ‐0.71]
9.11 Aprotinin: bolus versus continuous infusion 1 23 Std. Mean Difference (IV, Fixed, 95% CI) 0.86 [‐0.00, 1.73]
9.12 Aprotinin: high dose versus medium dose 1 189 Std. Mean Difference (IV, Fixed, 95% CI) 0.16 [‐0.12, 0.45]
9.13 Aprotinin: high dose versus low dose 1 20 Std. Mean Difference (IV, Fixed, 95% CI) ‐1.46 [‐2.47, ‐0.45]
9.14 Whole blood versus blood components 1 33 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.04 [‐0.72, 0.65]
9.15 Solvent detergent plasma versus standard fresh frozen plasma 1 25 Std. Mean Difference (IV, Fixed, 95% CI) 0.19 [‐0.60, 0.98]
9.16 Tranexamic acid versus EACA 1 84 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.23 [‐0.66, 0.20]
9.17 Tranexamic acid versus aprotinin 3 198 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.09 [‐0.36, 0.19]
10 Platelet transfusion 21   Std. Mean Difference (IV, Fixed, 95% CI) Subtotals only
10.1 Aprotinin versus control 5 185 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.44 [‐0.73, ‐0.14]
10.2 Tranexamic acid versus control 4 159 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.17 [‐0.49, 0.16]
10.3 Epsilon amino caproic acid (EACA) versus control 1 62 Std. Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.52, 0.55]
10.4 Antithrombin III versus control 1 29 Std. Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.73, 0.73]
10.5 Recombinant factor VIIa (rFVIIa) versus control 2 216 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.03 [‐0.31, 0.25]
10.6 Oestrogen versus control 1 30 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.53 [‐1.26, 0.20]
10.7 Norepinephrine versus control 1 65 Std. Mean Difference (IV, Fixed, 95% CI) 0.34 [‐0.15, 0.83]
10.8 Thromboelastography versus control 1 28 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.17 [‐0.91, 0.58]
10.9 Aprotinin: high dose versus medium dose 1 189 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.48 [‐0.77, ‐0.19]
10.10 Whole blood versus blood components 1 33 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.12 [‐0.81, 0.56]
10.11 Solvent detergent plasma versus standard fresh frozen plasma 1 25 Std. Mean Difference (IV, Fixed, 95% CI) 0.07 [‐0.71, 0.86]
10.12 Tranexamic acid versus EACA 1 84 Std. Mean Difference (IV, Fixed, 95% CI) 0.05 [‐0.37, 0.48]
10.13 Tranexamic acid versus aprotinin 3 198 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.08 [‐0.36, 0.20]
11 Plasma transfusion 25   Std. Mean Difference (IV, Fixed, 95% CI) Subtotals only
11.1 Aprotinin versus control 8 420 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.33 [‐0.53, ‐0.13]
11.2 Tranexamic acid versus control 4 159 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.21 [‐0.53, 0.11]
11.3 Epsilon amino caproic acid (EACA) versus control 1 62 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.12 [‐0.66, 0.41]
11.4 Antithrombin III versus control 1 29 Std. Mean Difference (IV, Fixed, 95% CI) 0.04 [‐0.69, 0.77]
11.5 Recombinant factor VIIa (rFVIIa) versus control 2 262 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.01 [‐0.28, 0.25]
11.6 Oestrogen versus control 1 30 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.67 [‐1.41, 0.07]
11.7 Prostaglandin versus control 1 20 Std. Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.88, 0.88]
11.8 Norepinephrine versus control 1 65 Std. Mean Difference (IV, Fixed, 95% CI) 0.11 [‐0.38, 0.60]
11.9 Thromboelastography versus control 1 28 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.82 [‐1.60, ‐0.05]
11.10 Aprotinin: bolus versus continuous infusion 1 23 Std. Mean Difference (IV, Fixed, 95% CI) 0.05 [‐0.78, 0.87]
11.11 Aprotinin: high dose versus medium dose 1 189 Std. Mean Difference (IV, Fixed, 95% CI) 0.06 [‐0.22, 0.35]
11.12 Aprotinin: high dose versus low dose 1 20 Std. Mean Difference (IV, Fixed, 95% CI) ‐1.31 [‐2.29, ‐0.32]
11.13 Whole blood versus blood components 1 33 Std. Mean Difference (IV, Fixed, 95% CI) ‐1.53 [‐2.32, ‐0.74]
11.14 Tranexamic acid versus EACA 1 84 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.22 [‐0.65, 0.21]
11.15 Tranexamic acid versus aprotinin 2 71 Std. Mean Difference (IV, Fixed, 95% CI) 0.02 [‐0.45, 0.48]
12 Cryoprecipitate 12   Std. Mean Difference (IV, Fixed, 95% CI) Subtotals only
12.1 Aprotinin versus control 3 147 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.49 [‐0.82, ‐0.16]
12.2 Tranexamic acid versus control 4 181 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.27 [‐0.57, 0.02]
12.3 Epsilon amino caproic acid (EACA) versus control 1 62 Std. Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.53, 0.54]
12.4 Antithrombin III versus control 1 29 Std. Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.73, 0.73]
12.5 Oestrogen versus control 1 30 Std. Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.72, 0.72]
12.6 Thromboelastography versus control 1 28 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.25 [1.00, 0.49]
12.7 Whole blood versus blood components 1 33 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.28 [‐0.97, 0.41]
12.8 Solvent detergent plasma versus standard fresh frozen plasma 1 25 Std. Mean Difference (IV, Fixed, 95% CI) 0.10 [‐0.68, 0.89]
12.9 Tranexamic acid versus EACA 1 62 Std. Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.69, 0.38]
13 Hospital stay 6   Mean Difference (IV, Fixed, 95% CI) Subtotals only
13.1 Aprotinin versus control 1 63 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐4.94, 4.94]
13.2 Tranexamic acid versus control 1 45 Mean Difference (IV, Fixed, 95% CI) 4.0 [‐16.18, 24.18]
13.3 Recombinant factor VIIa (rFVIIa) versus control 1 180 Mean Difference (IV, Fixed, 95% CI) 3.40 [‐7.51, 14.31]
13.4 Norepinephrine versus control 1 65 Mean Difference (IV, Fixed, 95% CI) ‐1.00 [‐3.18, 1.18]
13.5 Low central venous pressure versus control 1 86 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐19.43, 19.43]
13.6 Tranexamic acid versus aprotinin 1 51 Mean Difference (IV, Fixed, 95% CI) 5.0 [‐2.69, 12.69]
14 Intensive therapy unit stay 9   Mean Difference (IV, Fixed, 95% CI) Subtotals only
14.1 Aprotinin versus control 2 199 Mean Difference (IV, Fixed, 95% CI) ‐0.21 [‐0.78, 0.36]
14.2 Tranexamic acid versus control 1 45 Mean Difference (IV, Fixed, 95% CI) ‐1.0 [‐4.75, 2.75]
14.3 Recombinant factor VIIa (rFVIIa) versus control 2 199 Mean Difference (IV, Fixed, 95% CI) 0.22 [‐0.14, 0.58]
14.4 Norepinephrine versus control 1 65 Mean Difference (IV, Fixed, 95% CI) ‐0.13 [‐1.65, 1.39]
14.5 Low central venous pressure versus control 1 86 Mean Difference (IV, Fixed, 95% CI) ‐1.0 [‐3.71, 1.71]
14.6 Aprotinin: bolus versus continuous infusion 1 23 Mean Difference (IV, Fixed, 95% CI) 2.0 [‐3.99, 7.99]
14.7 Tranexamic acid versus aprotinin 1 51 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐2.40, 2.40]