Meta AnalysisID 3741
黄嘌呤氧化酶抑制剂在缺血再灌注损伤中的应用：一项系统评价
CRD42022365911
P: In patients undergoing surgical ischaemia/reperfusion to a limb (i.e amputation with replantation/induced ischaemia with torniquet/vascular insult with revascularisation) in both elective and emergency situations, doe
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Record Fields
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- Meta Analysis Id
- 3741
- Evidence Id
- 12299
- Core Evidence Id
- 12299
- Source Meta Analysis Id
- 3702
- Herb2 Meta Analysis Id
- HBMA003702
- Crd Id
- CRD42022365911
- Title
- Xanthine oxidase inhibitors in ischaemic reperfusion injury: A systematic review
- Review Question
- P: In patients undergoing surgical ischaemia/reperfusion to a limb (i.e amputation with replantation/induced ischaemia with torniquet/vascular insult with revascularisation) in both elective and emergency situations, does E: xanthine oxidase inhibitor administration (e.g. allopurinol) compared to C: No xanthine oxidase inhibition lead to O: differences in limb viability (and a subgroup as a function of ischaemia time), sensory function, post operative pain, wound complications, limb function, fasciotomies, or other outcomes defined by discovered literature. Study designs: all propsepctive and retrospective
- Study Type Included
- All study designs will be included.
- Condition Being Studied
- Ischaemia of a limb deprive it of the ability to undergo aerobic respiration. Eventually, the limb will become irreversibly damaged by ischaemia, making it nonviable. Reperfusion of an ischaemic limb is necessary to ensure viability, however; can cause damage through free radical formation. One metabolic pathway of xanthine oxidase is oxygen-dependant and releases oxygen free radicals in association with reperfusion.
- Participant
- Children and adults, males and females, undergoing isolated limb (or part thereof) ischaemia. Including torniquet application in both elective and emergency settings (including pre-hospital application), amputations with replantation, vascular insult (e.g. arterial occlusion or venous occlusion). We will include patients with hypovolaemic shock due to an isolated limb injury/amputation. Exclusions: limb ischaemia associated with generalised shocked haemodynamic state (E.g. septic shock causing peripheral necrosis, hypovolaemic shock with causes other than isolated limb trauma), transplant surgery.
- Animal
- Human Disease Modelled
- Intervention
- Administration of Xanthine oxidase inhibitor (e.g. allopurinol). Including regular pre-ischaemia administration for an alternate pathology (e.g. gout), experimental administration of oral or parenteral xanthine oxidase inhibitor either pre-ischaemia, intra-ischaemia, or post-ischaemia including post-reperfusion.
- Comparator Control
- No exposure to xanthine oxidase inhibitors.
- Main Outcome
- Limb viability at final follow-up (at least 30 days). Measures of effect odds ratio
- Outcome Measure
- Additional Outcome
- Pain (VAS), Sensation (2-point discrimination, formal neurological testing), wound complications, limb function, fasciotomies, or other outcomes defined by discovered literature.
- Study Method
- Intervention, Systematic review
- Keyword
- Allopurinol; Amputation; Humans; Ischemia; Pain, Postoperative; Reperfusion; Reperfusion Injury; Replantation; Retrospective Studies; Sensation; Xanthine Oxidase
- Contact
- Jeremy Abetz [email protected]
- Organisational Affiliation
- Grampians Health https://grampianshealth.org.au/
- Funding Source
- Nil financial interests. Sponsored by Dr Jeremy Abetz
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Australia
- Review Stage
- Review Ongoing
- First Submission Date
- 2022-10-10
- Registration Date
- 2022-10-21
- Anticipated Start Date
- 2022-11-01
- Anticipated Completion Date
- 2023-02-01
- Title Cn
- 黄嘌呤氧化酶抑制剂在缺血再灌注损伤中的应用：一项系统评价
- Title En
- Xanthine oxidase inhibitors in ischaemic reperfusion injury: A systematic review
- Bilingual Status
- complete