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Pediatric Cardiology

, Volume 26, Issue 5, pp 595–600 | Cite as

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

  • P. GesslerEmail author
  • V. Hohl
  • T. Carrel
  • J. Pfenninger
  • E.R. Schmid
  • O. Baenziger
  • R. Prètre
Article

Abstract

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.

Keywords

Congenital heart disease Cardiopulmonary bypass Inflammation Glucocorticoids 

Notes

Acknowledgments

The authors thank all perfusionists, especially E. Gygax (Department of Cardiovascular Surgery, Inselspital, Berne), as well as the nurses of the pediatric intensive care units in Zurich and Berne for their cooperation. This study was supported by a grant from EMDO Stiftung, Zurich, Switzerland.

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Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • P. Gessler
    • 1
    Email author
  • V. Hohl
    • 1
  • T. Carrel
    • 2
  • J. Pfenninger
    • 3
  • E.R. Schmid
    • 4
  • O. Baenziger
    • 1
  • R. Prètre
    • 5
  1. 1.University Children’s HospitalSwitzerland
  2. 2.Clinic for Cardiovascular SurgeryInselspitalBerneSwitzerland
  3. 3.University Children’s Hospital, InselspitalBerneSwitzerland
  4. 4.Division of Cardiovascular AnesthesiaUniversity HospitalZurichSwitzerland
  5. 5.Clinic for Cardiovascular SurgeryUniversity HospitalZurichSwitzerland

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