| Methylprednisolone reduces the inflammatory response to cardiopulmonary bypass in neonatal piglets: timing of dose is important. | |
| | |
MedLine Citation:
|
PMID: 10047655 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Cardiopulmonary bypass produces an inflammatory response that can cause significant postoperative pulmonary dysfunction and total body edema. This study evaluates the efficacy of preoperative methylprednisolone administration in limiting this injury in neonates and compares the effect of giving methylprednisolone 8 hours before an operation to the common practice of adding methylprednisolone to the cardiopulmonary bypass circuit prime. METHODS: A control group of neonatal pigs (control; n = 6) received no preoperative medication. One experimental group (n = 6) received methylprednisolone sodium succinate (30 mg/kg) both 8 and 1.5 hours before the operation. A second experimental group received no preoperative treatment, but methylprednisolone (30 mg/kg) was added to the cardiopulmonary bypass circuit prime. All animals underwent cardiopulmonary bypass and 45 minutes of deep hypothermic circulatory arrest. Hemodynamic and pulmonary function data were acquired before cardiopulmonary bypass and at 30 and 60 minutes after bypass. RESULTS: In the control group, pulmonary compliance, alveolar-arterial gradient, and pulmonary vascular resistance were significantly impaired after bypass (P <.01 for each by analysis of variance). In the group that received methylprednisolone, compliance (P =.02), alveolar-arterial gradient (P =.0003), pulmonary vascular resistance (P =.007), and extracellular fluid accumulation (P =.003) were significantly better after bypass when compared with the control group. Results for the group that received no preoperative treatment fell between the control group and the group that received methylprednisolone. CONCLUSIONS: When given 8 hours and immediately before the operation, methylprednisolone improves pulmonary compliance after bypass, alveolar-arterial gradient, and pulmonary vascular resistance compared with no treatment. The addition of methylprednisolone to the cardiopulmonary bypass circuit prime is beneficial but inferior to preoperative administration. |
| | |
Authors:
|
A J Lodge; P J Chai; C W Daggett; R M Ungerleider; J Jaggers |
Related Documents
:
|
803175 - Coronary artery perfusion. 8080375 - Use of carmeda-coated femoral-femoral bypass during repair of traumatic aortic pseudoan... 21963725 - Fever after percutaneous endovascular stent-graft in type b acute aortic dissection. 10475445 - Vascular clamp for hemostasis and stabilization during minimally invasive direct corona... 3355725 - Atrioventricular septal defect in prenatal life. 3223305 - Influence of renal denervation on vascular responsiveness of isolated rat intrarenal ar... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 117 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1999 Mar |
Date Detail:
|
Created Date: 1999-03-18 Completed Date: 1999-03-18 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 515-22 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, Duke University Medical Center, Durham, NC, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Animals, Newborn Anti-Inflammatory Agents / administration & dosage* Blood Pressure / drug effects Cardiopulmonary Bypass / adverse effects* Drug Administration Schedule Lung Compliance / drug effects Methylprednisolone / administration & dosage* Oxygen / blood Preoperative Care Pulmonary Circulation / drug effects Pulmonary Gas Exchange / drug effects Swine Systemic Inflammatory Response Syndrome / etiology, prevention & control* Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Inflammatory Agents; 7782-44-7/Oxygen; 83-43-2/Methylprednisolone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Long-term outcome of infants with single ventricle and total anomalous pulmonary venous connection.
Next Document: Comparison of longevity, pacing, and sensing characteristics of steroid-eluting epicardial versus co...