Administration of Steroids in Pediatric Cardiac Surgery: Impact on Clinical Outcome and Systemic Inflammatory Response
| Autor: | V. Hohl, Peter Gessler, Juerg Pfenninger, René Prêtre, Edith R. Schmid, Oskar Baenziger, Thierry Carrel |
|---|---|
| Přispěvatelé: | University of Zurich, Gessler, P |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Heart Defects
Congenital Inotrope medicine.medical_specialty Neutrophils Prednisolone Anti-Inflammatory Agents 610 Medicine & health Inflammation 142-005 142-005 2705 Cardiology and Cardiovascular Medicine law.invention Leukocyte Count chemistry.chemical_compound law medicine Cardiopulmonary bypass Humans Prospective Studies 2735 Pediatrics Perinatology and Child Health Cardiac Surgical Procedures Prospective cohort study Creatinine Cardiopulmonary Bypass business.industry Interleukin-8 Infant Vascular surgery Systemic Inflammatory Response Syndrome Cardiac surgery C-Reactive Protein Treatment Outcome chemistry Child Preschool Anesthesia Pediatrics Perinatology and Child Health medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers medicine.drug |
| Popis: | Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. Pre-bypass steroid administration may modulate the inflammatory response, resulting in improved postoperative recovery. We performed a prospective study in the departments of cardiovascular surgery and pediatric intensive care medicine of two university hospitals that included 50 infants who underwent heart surgery. Patients received either prednisolone (30 mg/kg) added to the priming solution of the cardiopulmonary bypass circuit (steroid group) or no steroids (nonsteroid group). Clinical outcome parameters include therapy with inotropic drugs, oxygenation, blood lactate, glucose, and creatinine, and laboratory parameters of inflammation include leukocytes, C-reactive protein, and interleukin-8. Postoperative recovery (e.g., the number, dosage, and duration of inotropic drugs as well as oxygenation) was similar in patients treated with or without steroids when corrected for the type of cardiac surgery performed. After CPB, there was an inflammatory reaction, especially in patients with a long CPB time. Postoperative plasma levels of interleukin-8 were correlated with the duration of CPB time (r = 0.62, p < 0.001). Administration of steroids had no significant impact on the laboratory parameters of inflammation. Administration of prednisolone into the priming solution of the CPB circuit had no measurable influence on postoperative recovery and did not suppress the inflammatory response. |
| Databáze: | OpenAIRE |
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