title: Dexamethasone reduces postoperative troponin levels in children undergoing cardiopulmonary bypass.
abstract: OBJECTIVE
  We previously demonstrated that dexamethasone treatment before cardiopulmonary bypass in children reduces the postoperative systemic inflammatory response. The purpose of this study was to test the hypothesis that dexamethasone administration before cardiopulmonary bypass in children correlates with a lesser degree of myocardial injury as measured by a decrease in cardiac troponin I release.
  
  
  METHODS
  A prospective, randomized, double-blind study.
  
  
  METHODS
  The cardiac surgery operating room and intensive care unit of a pediatric referral hospital.
  
  
  METHODS
  Twenty-eight patients who underwent open-heart surgery for congenital heart defects.
  
  
  METHODS
  Patients received either placebo (group I, n = 13) or dexamethasone, 1 mg/kg iv (group II, n = 15), 1 hr before initiation of cardiopulmonary bypass. Plasma cardiac troponin I samples were obtained at three time points: immediately before study agent (sample 1), 10 mins after protamine sulfate administration after cardiopulmonary bypass (sample 2), and 24 hrs postoperatively (sample 3).
  
  
  RESULTS
  Mean cardiac troponin I levels (+/-sd) were significantly lower at sample time 3 in group II (dexamethasone; 33.4 +/- 20.0 ng/mL) vs. group I (control; 86.9 +/- 81.1) (p =.04).
  
  
  CONCLUSIONS
  Dexamethasone administration before cardiopulmonary bypass in children resulted in a significant decrease in cardiac troponin I levels at 24 hrs postoperatively. We postulate that this may represent a decrease in myocardial injury, and, thus, a possible cardioprotective effect produced by dexamethasone.
authors.affiliation: Department of Surgery, Division of Pediatric Critical Care Medicine, Northwestern University Medical School, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Checchia
authors.forename: Carl L
authors.initials: CL
authors.lastname: Backer
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Bronicki
authors.forename: Harris P
authors.initials: HP
authors.lastname: Baden
authors.forename: Susan E
authors.initials: SE
authors.lastname: Crawford
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Green
authors.forename: Constantine
authors.initials: C
authors.lastname: Mavroudis
mesh_terms: D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000097:blood / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D011292:Premedication; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D019210:Troponin I / Q000097:blood*
chemical_list: D000893:Anti-Inflammatory Agents; D019210:Troponin I; D003907:Dexamethasone