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Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries
BACKGROUND: Cardiac surgery under Cardiopulmonary bypass causes a systemic inflammatory response with a multifactorial etiology including direct tissue damage, ischemia and stimulation of immune system induced by cardiopulmonary bypass. This study was designed due to the high prevalence and complica...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840835/ https://www.ncbi.nlm.nih.gov/pubmed/24349746 http://dx.doi.org/10.5812/ircmj.8105 |
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author | Soltani, Ghasem Abbasi Tashnizi, Mohammad Moeinipour, Ali Asghar Ganjifard, Mahmoud Esfahanizadeh, Jamil Sepehri Shamloo, Alireza Purafzali Firuzabadi, Seyed Javad Zirak, Nahid |
author_facet | Soltani, Ghasem Abbasi Tashnizi, Mohammad Moeinipour, Ali Asghar Ganjifard, Mahmoud Esfahanizadeh, Jamil Sepehri Shamloo, Alireza Purafzali Firuzabadi, Seyed Javad Zirak, Nahid |
author_sort | Soltani, Ghasem |
collection | PubMed |
description | BACKGROUND: Cardiac surgery under Cardiopulmonary bypass causes a systemic inflammatory response with a multifactorial etiology including direct tissue damage, ischemia and stimulation of immune system induced by cardiopulmonary bypass. This study was designed due to the high prevalence and complications of this stimulated immune system in mortality, morbidity, length of ICU stay, and mechanical ventilation. OBJECTIVES: This study was aimed to compare preoperative and intraoperative methylprednisolone (MP) to intraoperative MP alone with respect to postbypass inflammation and clinical outcome. PATIENTS AND METHODS: Sixty pediatric patients (age < 5years) undergoing cardiopulmonary bypass surgery between September 2011-2012 at Imam Reza hospital-Mashhad were randomly assigned to receive preoperative and intraoperative MP (group 1: 30 mg/kg, 4 hours before bypass and in bypass prime, n = 30) or intraoperative MP only (group 2: 30 mg/kg, n = 30). Postoperative temperature (peak temperature and average temperature during the first 24 hours), amount of inotropic, duration of mechanical ventilation, ICU stay, WBC, BUN, creatinine, and CRP were recorded and compared in both groups. Data were analyzed with SPSS version 13 by T-test, Mann-Whitney test if necessary, and Chi-squared distribution. RESULTS: Patient characteristics including age, weight, gender, and duration of bypass were almost similar in both groups (P > 0.05). No significant difference in amount of inotropic medications used for hemodynamic supports, duration of mechanical ventilation, peak and average temperature and length of ICU stay was observed. Among the laboratory tests (WBC, BUN, creatinine, CRP) only WBC counts raised more in group 2 when compared to group 1(P < 0.05). CONCLUSIONS: There was no difference in clinical outcome after cardiac surgery when we administered an additional dose of methylprednisolone compared to a single dose of methylprednisolone. |
format | Online Article Text |
id | pubmed-3840835 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-38408352013-12-12 Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries Soltani, Ghasem Abbasi Tashnizi, Mohammad Moeinipour, Ali Asghar Ganjifard, Mahmoud Esfahanizadeh, Jamil Sepehri Shamloo, Alireza Purafzali Firuzabadi, Seyed Javad Zirak, Nahid Iran Red Crescent Med J Research Article BACKGROUND: Cardiac surgery under Cardiopulmonary bypass causes a systemic inflammatory response with a multifactorial etiology including direct tissue damage, ischemia and stimulation of immune system induced by cardiopulmonary bypass. This study was designed due to the high prevalence and complications of this stimulated immune system in mortality, morbidity, length of ICU stay, and mechanical ventilation. OBJECTIVES: This study was aimed to compare preoperative and intraoperative methylprednisolone (MP) to intraoperative MP alone with respect to postbypass inflammation and clinical outcome. PATIENTS AND METHODS: Sixty pediatric patients (age < 5years) undergoing cardiopulmonary bypass surgery between September 2011-2012 at Imam Reza hospital-Mashhad were randomly assigned to receive preoperative and intraoperative MP (group 1: 30 mg/kg, 4 hours before bypass and in bypass prime, n = 30) or intraoperative MP only (group 2: 30 mg/kg, n = 30). Postoperative temperature (peak temperature and average temperature during the first 24 hours), amount of inotropic, duration of mechanical ventilation, ICU stay, WBC, BUN, creatinine, and CRP were recorded and compared in both groups. Data were analyzed with SPSS version 13 by T-test, Mann-Whitney test if necessary, and Chi-squared distribution. RESULTS: Patient characteristics including age, weight, gender, and duration of bypass were almost similar in both groups (P > 0.05). No significant difference in amount of inotropic medications used for hemodynamic supports, duration of mechanical ventilation, peak and average temperature and length of ICU stay was observed. Among the laboratory tests (WBC, BUN, creatinine, CRP) only WBC counts raised more in group 2 when compared to group 1(P < 0.05). CONCLUSIONS: There was no difference in clinical outcome after cardiac surgery when we administered an additional dose of methylprednisolone compared to a single dose of methylprednisolone. Kowsar 2013-06-05 2013-06 /pmc/articles/PMC3840835/ /pubmed/24349746 http://dx.doi.org/10.5812/ircmj.8105 Text en Copyright © 2013, Iranian Red Crescent Medical Journal http://creativecommons.org/licenses/by/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Soltani, Ghasem Abbasi Tashnizi, Mohammad Moeinipour, Ali Asghar Ganjifard, Mahmoud Esfahanizadeh, Jamil Sepehri Shamloo, Alireza Purafzali Firuzabadi, Seyed Javad Zirak, Nahid Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title | Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title_full | Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title_fullStr | Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title_full_unstemmed | Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title_short | Comparing the Effect of Preoperative Administration of Methylprednisolone and its Administration Before and During Surgery on the Clinical Outcome in Pediatric Open Heart Surgeries |
title_sort | comparing the effect of preoperative administration of methylprednisolone and its administration before and during surgery on the clinical outcome in pediatric open heart surgeries |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840835/ https://www.ncbi.nlm.nih.gov/pubmed/24349746 http://dx.doi.org/10.5812/ircmj.8105 |
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