Treatment and Prophylaxis of Post-pericardiotomy Syndrome in Cardiac Surgery Patients: a Systematic Review.

Purpose; Post-pericardiotomy syndrome (PPS) is a common complication of cardiac surgery. This systematic review aimedto 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 treatedwith colchicine, dexamethasone, and indomethacin and compared with placebo were included. Animal or in vitro experi-ments, studies on < 10 patients, case reports, congress reports, and review articles were excluded. Cochrane risk-of-bias toolfor 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 asignificant 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 preoperativedexamethasone intake. Conclusion; Better outcomes have been registered when colchicine and indomethacin were administered as primary prophy-lactic agents in preventing PPS and PE. Further RCT studies are needed to confirm these result