Document Detail


Routine use of corticosteroids to prevent inflammation response in cardiac surgery.
MedLine Citation:
PMID:  23035828     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Cardiac surgery, especially if it involves cardiopulmonary bypass, is associated with a severe systemic inflammatory response. It is characterized by complement activation and initiation of coagulation, fibrinolysis and kallikrein cascades. Consecutive activation of immunoregulatory cells results in an extensive release of pro- and anti-inflammatory cytokines. This inflammatory storm is related to organ dysfunction or failure and correlates with postoperative morbidity. In order to attenuate this deleterious inflammatory response in the perioperative period alternative surgical techniques, novel extracorporeal circulation devices and immunomodulatory pharmacological strategies are in focus of contemporary research. Since decades corticosteroids have been used and studied in patients undergoing cardiac surgery. Although it could be shown that glucocorticoids seem to change the pro-inflammatory cytokine profile in a favourable manner, it still remains controversial if this effect translates into a better clinical outcome. Several clinical trials have proclaimed an association between this inflammatory response and the incidence of major complications i.e, myocardial infarction and pulmonary complications, but until now they have failed to show conclusive results. This article describes the different types and recommended dose schemes of corticosteroids in the perioperative period of cardiac surgery. It will comment on potential side effects and review the effect on the postoperative outcome.
Authors:
Tim Nebelsiek; Andres Beiras-Fernandez; Erich Kilger; Patrick Möhnle; Florian Weis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-01
Journal Detail:
Title:  Recent patents on cardiovascular drug discovery     Volume:  -     ISSN:  2212-3962     ISO Abbreviation:  Recent Pat Cardiovasc Drug Discov     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101263805     Medline TA:  Recent Pat Cardiovasc Drug Discov     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiothoracic and Vascular Surgery, JW Goethe University Frankfurt, Theodor-Stern-Kai 7 61590 Frankfurt, Germany. Andres.Beiras@kgu.de.
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