The use of cardiopulmonary bypass involves exposing blood to the artificial surface of the extracorporeal circuit, which can trigger a systemic inflammatory response that influences postoperative outcome of the patients and increases mortality. The aim of our work is to study the effectiveness of anti-inflammatory effect of dexamethasone in cardiac surgery with cardiopulmonary bypass.
Materials and methods. We conducted a randomized clinical trial at Cardiovascular Surgery Targu Mures. We included 121 patients who undergo open heart surgery, 46 patients were in the control group (not receiving dexamethasone), 45 patients received 0,3 mg/kg dexamethasone postinduction, 30 patients received postinduction and in the first three postoperative days. We analyzed the intensity of inflammatory syndrome (temperature, leukocyte count) in function of cardiopulmonary bypass time and the amount of dexamethasone, we followed also the serum glucose level and gastric complaints.
Results. The intensity of the inflammatory response syndrome was lower in patients who had received dexamethasone, as well as the incidence of organ dysfunction (32.6% in control group vs. 11.11% in single dose and 20% in those who had received dexamethasone intra-and postoperative), mortality was twice as high in the control group. Blood glucose was 1,5 times higher in the study group compared to the control group, gastric complaints were not reported in any patient.
Conclusions. Low doses of dexamethasone had a favorable effect in reducing systemic inflammatory response syndrome and the incidence of postoperative adverse reaction of glucocorticoids were lower than those reported in the literature.
Keywords: cardiopulmonary bypass, systemic inflammatory response, dexamethasone.