Administration of Steroids in Pediatric Cardiac Surgery: Impact on Clinical Outcome and Systemic Inflammatory Response

Gessler, P.; Hohl, V.; Carrel, T.; Pfenninger, J.; Schmid, E. R.; Baenziger, O.; Prètre, R.
September 2005
Pediatric Cardiology;Sep/Oct2005, Vol. 26 Issue 5, p595
Academic Journal
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.


Related Articles

  • Right Ventricular Outflow Tract Transannular Patch Placement without Cardiopulmonary Bypass. Levi, D. S.; Glotzbach, J. P.; Williams, R. J.; Myers, J. L.; Laks, H. // Pediatric Cardiology;Jan/Feb2006, Vol. 27 Issue 1, p149 

    In children with pulmonary atresia not amenable to initial complete correction, antegrade pulmonary blood flow can be established with surgical right ventricular outflow tract (RVOT) patch enlargement. An 11-year experience with RVOT transannular patch (TAP) augmentation without the use of...

  • Capillary leak syndrome in children who undergo cardiopulmonary bypass: clinical outcome in comparison with complement activation and C1 inhibitor. Stiller, Brigitte; Sonntag, Josef; Dähnert, Ingo; Alexi-Meskishvili, Vladimir; Hetzer, Roland; Fischer, Thomas; Lange, Peter E.; Stiller, B; Sonntag, J; Dähnert, I; Alexi-Meskishvili, V; Hetzer, R; Fischer, T; Lange, P E // Intensive Care Medicine;Jan2001, Vol. 27 Issue 1, p193 

    Objectives: Capillary leak syndrome (CLS) is associated with significantly increased morbidity and occurs after cardiopulmonary bypass in children with congenital heart disease. We investigated the early clinical parameters that predict the development of CLS and examined the...

  • The systemic delivery and consumption of oxygen in the infant after cardiac surgery. Penny, Daniel J. // Cardiology in the Young;Sep2006 Supplement, Vol. 16 Issue S3, p144 

    The article examines the relationship between the delivery and consumption of oxygen in infants following cardiac surgery. It is inferred that the essential function of cardiopulmonary system is to generate sufficient flow of oxygenated blood to maintain normal cellular metabolism. Infusions of...

  • Has Triiodothyronine Treatment of Children after Cardiopulmonary Bypass Surgery Any Long-Term Effects? Deladoëy, Johnny; Harrington, Karen // Hormone Research in Paediatrics;Sep2015, Vol. 84 Issue 2, p137 

    No abstract available

  • Inflammatory response of neutrophil granulocytes and monocytes after cardiopulmonary bypass in pediatric cardiac surgery. Gessler, Peter; Pfenninger, Juerg; Pfammatter, Jean-Pierre; Carrel, Thierry; Dahinden, Clemens // Intensive Care Medicine;Dec2002, Vol. 28 Issue 12, p1786 

    Objective. To determine whether the activation state of polymorphonuclear neutrophils (PMNs) and monocytes contributes to the inflammatory response after cardiopulmonary bypass (CPB) in pediatric cardiac surgery. Design. Observational prospective clinical study. Setting. Pediatric intensive care...

  • Renal function and cardiopulmonary bypass in pediatric cardiac surgical patients. Lema, Guillermo; Vogel, Andrea; Canessa, Roberto; Jalil, Roberto; Carvajal, Claudia; Becker, Pedro; Jaque, Maria; Fajardo, Christian; Urzua, Jorge // Pediatric Nephrology;Oct2006, Vol. 21 Issue 10, p1446 

    We studied prospectively the perioperative changes of renal function in nine children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with inulin and 131I-hippuran clearances before CPB, during...

  • Factors affecting postoperative blood loss in children undergoing cardiac surgery. Faraoni, David; Van der Linden, Philippe // Journal of Cardiothoracic Surgery;2014, Vol. 9 Issue 1, p1 

    We hypothesized that the influence of cyanotic disease on postoperative blood loss is closely related to age in children undergoing cardiac surgery. Here, we demonstrate that the presence of a cyanotic disease is associated with increased postoperative blood loss in children aged 1 to 6 months....

  • Effects of fresh versus old stored blood in the priming solution on whole blood lactate levels during paediatric cardiac surgery. Schroeder, Torsten H.; Hansen, Matthias // Perfusion;Jan2005, Vol. 20 Issue 1, p17 

    It has been suggested that lactate levels may predict morbidity and mortality in paediatric patients during corrective open-heart surgery. Packed red blood cells (PRBC) are frequently necessary for priming the reservoir used in cardiopulmonary bypass (CPB). The storage of PRBC might cause a...

  • Hybrid Pediatric Cardiac Surgery. Bacha, E. A.; Hijazi, Z. M.; Cao, Q.-L.; Abdulla, R.; Starr, J. P.; Quinones, J.; Koeing, P.; Agarwala, B. // Pediatric Cardiology;Jul/Aug2005, Vol. 26 Issue 4, p315 

    Minimally invasive strategies can be expanded by combining standard surgical and interventional techniques. We performed a longitudinal prospective study of all pediatric patients who have undergone hybrid cardiac surgery at the University of Chicago Children's Hospital. Hybrid cardiac surgery...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics