Ma. Chaney et al., Hemodynamic effects of methylprednisolone in patients undergoing cardiac operation and early extubation, ANN THORAC, 67(4), 1999, pp. 1006-1011
Citations number
24
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. Whether or not methylprednisolone is beneficial during cardiac
operation remains controversial. This study examines the effects of the dru
g on complement activation and hemodynamics in patients undergoing cardiac
operation and early extubation.
Methods. Patients undergoing cardiac operation were randomized to receive e
ither intravenous methylprednisolone (group MP) or intravenous placebo (gro
up NS). Complement 3a (C3a) levels and hemodynamic parameters were obtained
perioperatively. Extubation was accomplished at the earliest clinically ap
propriate time.
Results. Both groups exhibited equivalent increases in C3a levels after exp
osure to bypass. Group MP exhibited increased cardiac index, decreased syst
emic vascular resistance, and increased shunt flow when compared to group N
S. More group MP patients required hemodynamic support and group MP patient
s had prolonged extubation times.
Conclusions. Methylprednisolone was unable to attenuate complement activati
on and led to hemodynamic alterations (primarily vasodilation) that may hin
der early extubation in patients after cardiac operations. (Ann Thorac Surg
1999;67:1006-11). (C) 1999 by The Society of Thoracic Surgeons.