The effect of hemofilter, preoperative and intraoperative methylprednisolone on complications after open heart surgery

Abstract

Complications after open heart surgery may threaten patient's survival rate. The intraoperative methylprednisolone administration alone shows controversial results on open heart surgery complications. Similarly, the intraoperative and preoperative methylprednisolone administration as well as the use of hemofilter in open heart surgery is still controversial. This study aimed to evaluate the effect of hemofilter, preoperative and intraoperative methylprednisolone administration on complications following open heart surgery. This was a Prospective Randomized Open-Blinded Evaluation (PROBE) experimental study. Ninety-five patients who had open heart surgery in Dr. Sardjito General Hospital, Yogyakarta, and Integrated Cardiac Care of Dr. Cipto Mangunkusumo General Hospital, Jakarta within the period of December 2011 to May 2012 were involved in this study. The patients were divided into two groups i.e. group A, 48 patients received methylprednisolone 15mg/kg intraoperatively, methylprednisolone 5mg/kg preoperatively, and hemofilter, while group B, 47 patients received methylprednisolone 15mg/kg intraoperatively alone. From the total 95 patients, we found 26 (27.4%) patients experienced complications i.e. 19 in group B (40.4%) and 7 in group A (14.6%). The differences of the complications were statistically significant (p<0.05; OR=3.97; 95%CI=1.476-10.71). Complications risk decreased by 63.9% in the group A compared to the group B with the hazard ratio of 3.2. In conclusion, the application of hemofilter, preoperative and intraoperative methylprednisolone might decrease the risk of complications after open heart surgery. ABSTRAKKomplikasi paska bedah jantung terbuka dapat mempengaruhi angka harapan hidup pasien. Pemberian intraoperatif metilpredinsolon saja untuk mencegah komplikasi paska bedah jantung terbuka masih menunjukkan hasil yang kontroversial. Pemberian metilprednisolon preoperatif dan intraoperatif serta penggunaan hemofilter masih kontroversial. Penelitian ini bertujuan untuk mempelajari efek hemofilter, pemberian preoperatif dan intraoperatif metilprednisolon terhadap komplikasi paska bedah jantung terbuka. Penelitian ini merupakan studi eksperimental dengan desain Prospective Randomized Open-Blinded Evaluation (PROBE). Didapatkan 95 pasien yang menjalani bedah jantung terbuka di Rumah Sakit