Corticosteroids and cardiopulmonary bypass : a review of clinical investigations.
Traditionally, corticosteroids have been administered to patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) to ward off detrimental physiologic alterations associated with activation of the systemic inflammatory response, yet few well-controlled investigations exist, and use of these drugs in this setting remains controversial. This review article critically examines the results of clinical investigations in this area, and certain conclusions are suggested. The constellation of findings indicate that corticosteroids offer no clinical benefits to patients undergoing cardiac surgery with CPB and in fact may be detrimental. Further directions for clinical research in this area are also suggested.
Chaney
Mark A
MA
Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL 60637, USA. mchaney@aryaw.uchicago.edu
D000818:Animals; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003167:Complement Activation / Q000187:drug effects / Q000502:physiology; D005938:Glucocorticoids / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008775:Methylprednisolone / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D010106:Oxygenators; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*
D005938:Glucocorticoids; D008775:Methylprednisolone