Intraoperative dexamethasone is associated with a lower risk of respiratory failure in thoracic surgery: Observational cohort study (SURTHODEX).

Autor: Braik R; Sorbonne University, GRC 29, AP-HP, DMU DREAM and Department of Anaesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France. Electronic address: rayan.braik@aphp.fr., Germain Y; Poly clinique Saint Côme, Service d'anesthésie-réanimation, Compiègne, France., Flet T; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France., Chaba A; Department of Intensive Care, Austin Hospital, Melbourne, Australia., Guinot PG; Centre hospitalier universitaire de Dijon, Département d'anesthésie-réanimation, Dijon, France., Garreau L; Centre hospitalier universitaire de Bordeaux, Département d'anesthésie-réanimation, Bordeaux, France., Bar S; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France., Diouf M; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France., Abou-Arab O; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France., Mahjoub Y; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France., Berna P; Clinique Victor Pauchet, Service de chirurgie thoracique, Amiens France., Dupont H; Centre hospitalier universitaire d'Amiens, Département d'anesthésie-réanimation, Amiens, France.
Jazyk: angličtina
Zdroj: Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2024 Aug; Vol. 43 (4), pp. 101386. Date of Electronic Publication: 2024 May 06.
DOI: 10.1016/j.accpm.2024.101386
Abstrakt: Background: Postoperative complications, particularly respiratory complications, are of significant clinical concern in patients undergoing elective thoracic surgery. Dexamethasone (DXM), commonly administered to prevent postoperative nausea and vomiting (PONV), has potential anti-inflammatory effects that might be beneficial in reducing these complications. We aimed to investigate whether intraoperative DXM administration could mitigate the occurrence of respiratory complications following elective thoracic surgery.
Methods: We conducted a single-center observational study, including patients who underwent elective thoracic surgery from 2012 to 2020. The primary outcome was the onset of acute respiratory failure within 7 days post-surgery. Secondary outcomes encompassed other postoperative complications, duration of hospital stay, and mortality within 30 days post-surgery. An overlap propensity score analysis was employed to estimate the treatment effect.
Results: We included 1,247 adult patients, 897 who received dexamethasone (DXM) and 350 who served as controls. Intraoperative dexamethasone administration was associated with a significant reduction in respiratory complications with an adjusted relative risk (RR) of 0.65 (95% CI: 0.43-0.97). There was also a significant decline in composite infectious criteria with an adjusted RR of 0.76 (95% CI: 0.63-0.93). Cardiac complications were also assessed as a composite criterion, and a significant reduction was observed (adjusted RR, 0.68; 95% CI, 0.51-0.9). However, there were no association with mechanical complications, mortality within 30 days (adjusted RR of 0.43, 95% CI: 0.17-1.09) or in the length of hospital stay (adjusted RR of 0.85, 95% CI: 0.71-1.02).
Conclusions: Dexamethasone administration was associated with a reduction in postoperative respiratory complications. Further prospective studies are needed to confirm these findings.
(Copyright © 2024 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: