Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial
| Autor: | Marium Muzaffar, Khabir Ahmad, Muhammad Muneer Amanullah, Shahjahan Khan, Zahra Hasan, Mohammad Hamid, Hashim M Hanif, Fatima Adhi, Maria Tariq Siddiqui |
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| Rok vydání: | 2015 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Heart disease Adolescent Inflammation 030204 cardiovascular system & hematology Placebo Dexamethasone Proinflammatory cytokine law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Double-Blind Method law Immunopathology Cardiopulmonary bypass medicine Humans Pakistan 030212 general & internal medicine Child Cardiopulmonary Bypass business.industry Tumor Necrosis Factor-alpha Infant General Medicine medicine.disease Surgery Child Preschool Pediatrics Perinatology and Child Health Cytokines Administration Intravenous Female medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers medicine.drug |
| Zdroj: | Cardiology in the young. 26(3) |
| ISSN: | 1467-1107 1047-9511 |
| Popis: | BackgroundCardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters.ObjectiveTo assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery.Materials and methodsA randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010–2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines – Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha – were measured. Clinical parameters were also assessed.ResultsBlood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (pConclusionDexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term. |
| Databáze: | OpenAIRE |
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