Journal article
Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial
Cardiology in the young, Vol.26(3), pp.506-515
03/01/2016
DOI: 10.1017/S1047951115000566
PMID: 25917060
Abstract
Background: Cardiopulmonary 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. Objective: To assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery. Materials and methods: A 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. Results: Blood 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 (p < 0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p < 0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups. Conclusion: Dexamethasone 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.
Details
- Title: Subtitle
- Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial
- Creators
- Muhammad M. Amanullah - University of KarachiMohammad Hamid - University of KarachiHashim M. Hanif - University of KarachiMarium Muzaffar - University of KarachiMaria T. Siddiqui - University of KarachiFatima Adhi - University of KarachiKhabir Ahmad - University of KarachiShahjahan Khan - Agha Khan Univ, Med Coll, Karachi, PakistanZahra Hasan - AKUH, Dept Pathol & Microbiol, Karachi, Pakistan
- Resource Type
- Journal article
- Publication Details
- Cardiology in the young, Vol.26(3), pp.506-515
- DOI
- 10.1017/S1047951115000566
- PMID
- 25917060
- NLM abbreviation
- Cardiol Young
- ISSN
- 1047-9511
- eISSN
- 1467-1107
- Publisher
- Cambridge Univ Press
- Number of pages
- 10
- Grant note
- URC-0911024SUR / University Research Council Grant, The Aga Khan University
- Language
- English
- Date published
- 03/01/2016
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984848422502771
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