Minor infection encouraged by steroid administration during cardiac surgery.
The aim of this study was to investigate whether steroid administration would increase the risk of postoperative infection. Sixty adults who underwent elective cardiac surgery under cardiopulmonary bypass were prospectively randomized into two groups. Thirty-one patients received hydrocortisone (50 mg x kg(-1)) before and after cardiopulmonary bypass, the other 29 served as controls. Various hemodynamic and pulmonary measurements were obtained perioperatively, and the white blood cell counts and levels of C-reactive protein were checked up to the 14(th) postoperative day. Steroid administration did not have any favorable effects during the perioperative period. Re-administration of antibiotics was needed in 7 patients (22.6%) after the 7(th) postoperative day in the steroid group, and in 3 (10.3%) in the control group. The peak white cell counts and C-reactive protein levels after the 7(th) postoperative day were significantly higher in the steroid group. Steroid administration offered no clinical benefit to patients undergoing cardiac surgery with cardiopulmonary bypass, and it may encourage minor infections in the late postoperative period.
Sano
Tetsuro
T
Department of Cardiovascular Surgery, Graduate School of Medical Sciences, The Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582, Japan. tsanokyu@yahoo.co.jp
Morita
Shigeki
S
Masuda
Munetaka
M
Yasui
Hisataka
H
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects*; D007239:Infections / Q000188:drug therapy* / Q000209:etiology; D007249:Inflammation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D006854:Hydrocortisone