title: Role of methylprednisolone in the prevention of postpericardiotomy syndrome after cardiac surgery.
abstract: OBJECTIVE
  Postpericardiotomy syndrome (PPS) occurs in 10-40% of patients after cardiac operations. Pericardial effusions and tamponade occurring > 7 days after surgery are usually related to PPS and remain an important cause of cardiac surgery-related morbidity and mortality; therefore, preventing PPS is important. Colchicine affords safe and efficacious protection against PPS and related complications. However, the roles of corticosteroids and nonsteroidal anti-inflammatory drugs in PPS prevention remains unclear. This study aimed to determine whether the intraoperative use of single-dose methylprednisolone can effectively prevent PPS.
  
  
  METHODS
  This retrospective study included 100 patients undergoing elective coronary artery bypass grafting (CABG) who received a single intraoperative dose of 1 mg/kg methylprednisolone. A further 100 patients undergoing CABG, who were not given methylprednisolone, comprised the control group. The presence and severity of pericardial effusion was determined by echocardiography, with chest X-ray used to assess pleural effusion.
  
  
  RESULTS
  PPS occurrence and pericardial effusion occurrence were significantly lower in patients who received methylprednisolone (p = 0.02 and p = 0.007 respectively). Although the differences were not statistically significant, pericardial and pleural effusions were more severe in the control group than in the methylprednisolone group. Logistic regression analysis demonstrated that methylprednisolone administration was independently associated with prevention of PPS (OR 0.8, 95% CI 0.25-0.91, p <  0.026).
  
  
  CONCLUSIONS
  Intraoperative, single-dose methylprednisolone may confer protection against PPS in patients undergoing CABG.
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey. utkansevuk@gmail.com.
authors.forename: U
authors.initials: U
authors.lastname: Sevuk
authors.forename: E
authors.initials: E
authors.lastname: Baysal
authors.forename: R
authors.initials: R
authors.lastname: Altindag
authors.forename: B
authors.initials: B
authors.lastname: Yaylak
authors.forename: M S
authors.initials: MS
authors.lastname: Adiyaman
authors.forename: N
authors.initials: N
authors.lastname: Ay
authors.forename: U
authors.initials: U
authors.lastname: Beyazit
authors.forename: V
authors.initials: V
authors.lastname: Alp
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011185:Postpericardiotomy Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone