Hemodynamic effects of methylprednisolone in patients undergoing cardiac operation and early extubation.
BACKGROUND
Whether or not methylprednisolone is beneficial during cardiac operation remains controversial. This study examines the effects of the drug on complement activation and hemodynamics in patients undergoing cardiac operation and early extubation.


METHODS
Patients undergoing cardiac operation were randomized to receive either intravenous methylprednisolone (group MP) or intravenous placebo (group NS). Complement 3a (C3a) levels and hemodynamic parameters were obtained perioperatively. Extubation was accomplished at the earliest clinically appropriate time.


RESULTS
Both groups exhibited equivalent increases in C3a levels after exposure to bypass. Group MP exhibited increased cardiac index, decreased systemic vascular resistance, and increased shunt flow when compared to group NS. More group MP patients required hemodynamic support and group MP patients had prolonged extubation times.


CONCLUSIONS
Methylprednisolone was unable to attenuate complement activation and led to hemodynamic alterations (primarily vasodilation) that may hinder early extubation in patients after cardiac operations.
D000328:Adult; D000368:Aged; D003167:Complement Activation / Q000187:drug effects; D015926:Complement C3a / Q000032:analysis; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology*; D008875:Middle Aged; D011446:Prospective Studies; D014655:Vascular Resistance / Q000187:drug effects