Effect of Timing and Route of Methylprednisolone Administration During Pediatric Cardiac Surgical Procedures

Keski‐Nisula, Juho; Suominen, Pertti; Olkkola, Klaus T.; Peltola, Kaija; Neuvonen, Pertti J.; Tynkkynen, Paula; Salminen, Jukka; Andersson, Sture; Pesonen, Eero

doi:10.1016/j.athoracsur.2014.08.042

Cited by 30 publications

(57 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed all significant differences between the study groups at 6 hours after CPB. All the major weaknesses of the present study are related to the fact that the analyzed sample series originate from trials that originally were not tailored to study NGAL or AKI (13,14). Because we did not collect urine samples, the study cannot provide an answer the intriguing question of the influence of corticosteroids on urine NGAL concentrations.…”

Section: Discussionmentioning

confidence: 83%

“…The sample series of the present study originate from two previous clinical trials, power analyses of which were calculated for plasma interleukin concentrations (13,14). Thus, power analysis for creatinine, NGAL, or lactoferrin has not been conducted.…”

Section: Methodsmentioning

confidence: 99%

“…This study comprises novel unpublished data of two previously published, separate, double-blind, placebo-controlled, randomized (sealed envelope) clinical trials (European Union Controlled Trial Register, EudraCT 2008-007413-76) that focused on the anti-inflammatory and cardioprotective effects of MP (13,14). Both studies were approved by the local ethics committee, and a signed parental consent was obtained for each patient before enrolment into the study.…”

Section: Methodsmentioning

confidence: 99%

“…In the VSD trial, lactoferrin was also analyzed using commercial ELISA kits (Hycult Biotech, Uden, The Netherlands). The ELISA determinations were carried out on the excess plasma samples that had originally been collected for the previous two randomized control trial studies (13,14).…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase–Associated Lipocalin in Pediatric Heart Surgery*

Pesonen

Suominen

Keski‐Nisula

et al. 2016

Pediatric Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

Preoperatively administered methylprednisolone profoundly decreases plasma neutrophil gelatinase-associated lipocalin levels. Neutrophil gelatinase-associated lipocalin seems to originate to a significant extent from activated neutrophils. Preoperative methylprednisolone is a confounding factor when interpreting plasma neutrophil gelatinase-associated lipocalin levels as a kidney injury marker in pediatric heart surgery.

show abstract

Section: Discussionmentioning

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase–Associated Lipocalin in Pediatric Heart Surgery*

Pesonen

Suominen

Keski‐Nisula

et al. 2016

Pediatric Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Another RCT found no differences between the single intraoperative dose of steroid and double (pre-operative and intraoperative doses) [23]. One study investigated the effect of steroid administered intravenously versus steroid in prime and found no differences [24]. Due to the limitations of the randomised evidence described above, the resulting meta-analyses are of limited value too [25,26].…”

Section: Less Inflammation Better Clinical Outcomes?mentioning

confidence: 99%

Steroids in paediatric heart surgery: eminence or evidence-based practice?

Fudulu

Lightman

Caputo

et al. 2018

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Steroids in paediatric heart surgery are given prophylactically to blunt the systemic inflammatory response induced by the extracorporeal circuit and to improve clinical outcomes. However, there is an ongoing controversy about the impact of steroids on clinical outcomes after paediatric heart surgery. The hypothalamic-pituitary-adrenal axis is the primary neuroendocrine system activated during the stress of surgery. Relative adrenal insufficiency can accompany paediatric heart surgery; therefore, perioperative steroid supplementation is still administered by some centres. The studies that investigate the hypothalamic-pituitaryadrenal axis physiology during surgery have many limitations, and it is unclear how to define what is adrenal insufficiency. In this review, we focus on discussing the available evidence for steroid use in paediatric cardiac surgery.

show abstract

Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass

Gibbison

Villalobos-Lizardi

Martínez

et al. 2018

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the benefits and harms of prophylactic corticosteroids in children between birth and 18 years of age undergoing cardiac surgery with cardiopulmonary bypass. B A C K G R O U N D Description of the condition Paediatric heart surgery outcomes have improved markedly over time as a result of marginal gains in training, technology and safety systems (Brown 2015; Hoashi 2015; Jacobs 2016; NICOR 2016). This improvement has been particularly notable in the last 20 years: the publication of heart surgery outcomes after the Kennedy Inquiry in the UK has been associated with a large increase in survival for risk-adjusted surgery (Kennedy 2001; Grant 2013). This has been mirrored worldwide (Brown 2015; Hoashi 2015; Jacobs 2016). One area where there is still controversy is corticosteroid use. Paediatric heart surgery with the use of cardiopulmonary bypass results in a systemic inflammatory response; corticosteroids have been widely used to mitigate the potential deleterious effects of this response. The surgical intervention for which corticosteroids are used includes a variety of surgeries performed on the heart and great vessels. In most cases this procedure aims to correct congenital heart diseases (i.e. heart malformations that the child is born with). In most cases (78% in the UK) (NICOR 2016), surgery will take place with the use Cardio-Pulmonary By-1 Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass (Protocol)

show abstract

Effect of Timing and Route of Methylprednisolone Administration During Pediatric Cardiac Surgical Procedures

Cited by 30 publications

References 22 publications

The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase–Associated Lipocalin in Pediatric Heart Surgery*

The Effect of Methylprednisolone on Plasma Concentrations of Neutrophil Gelatinase–Associated Lipocalin in Pediatric Heart Surgery*

Steroids in paediatric heart surgery: eminence or evidence-based practice?

Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass

Contact Info

Product

Resources

About