Effects of Postinduction Administration of Dexamethasone in Preventing Postcardiac Surgery Complications

Written by Szomorú Ildikó-Pálma, Kovács Judit , Vass Katalin

Background: Much of the complications occuring after heart surgery can be attributed to systemic inflammatory reaction, caused by the use of extracorporeal circulation. Corticosteroids act through nuclear transcription factor-κB (NF-κB), decreasing the amount of inflammatory mediators.

Material and methods: We performed a prospective clinical study on 40 patients undergoing elective cardiac surgery (coronary artery bypass graft, valve replacement or combination of two) using extracorporeal circulation; 10 of them received dexamethasone immediately after induction of anesthesia. We investigated the incidence of postoperative complications particularly the neurologic complications and inflammatory response, depeding on antiinflammatory therapy received. 

Results: Patients receiving dexamethasone were less likely to develop complications in the immediately postoperative period (30,00% vs 66,67%, p=0,0486) and had a lower incidence of postoperative fever (10,00% vs 53,33%, p=0,0177). However, we could not demonstrate statistical differences in the occurence of neurological complications, new onset atrial fibrillation, inotropic drug requirements or length of stay in the intensive care unit. Conclusions: According to our study, dexamethasone has a positive effect on postoperative outcome after cardiac surgery, particularly reducing the complications attributed to the inflammatory response but does not influence neurological complications or lenght of stay in intensive care.

Keywords: corticosteroids, dexamethasone, anesthesia, cardiac surgery.

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