STEROIDS IN CARDIAC SURGERY: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.53555/nnmhs.v9i6.1725Keywords:
Cardiac surgery, Dellirium, Infection, SteroidsAbstract
Since there has been considerable research on the prophylactic administration of corticosteroids in adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), there is limited evidence to suggest that steroid therapy substantially affects patient outcomes.
Objective: This study aims to investigate the effects of administering steroids during cardiac surgery.
Aim: This study complied with the PRISMA 2020 guidelines for systematic review and meta-analysis. The researchers verified the study's similarity to become feasible. Publications from 2015 to 2023 were searched using online reference databases, including Pubmed and SagePub. Review articles, previously published works, and incomplete articles were dismissed.
Methods: The search identified 9,316 articles in PubMed and 7,654 articles in SagePub. In 2015, a search on PubMed identified 238 articles, and a search on SagePub yielded 121 articles. At last, 27 papers were selected, with 15 sourced from PubMed and 12 from SagePub. We included five studies that met the criteria.
Conclusion: The relationship between prescribing steroids and surgical site infections is still debated. Corticosteroid therapy has been found to reduce the incidence of postoperative delirium.
References
Zipes D, Libby P, Bonow R. Braunwald’s Heart Disease. 8th ed. Elsevier; 2019.
Ponikowski P; Voors AA; Anker SD; et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(27):2129-2200.
Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. 2021;11(2):169-177. doi:10.2991/jegh.k.201217.001 [4] Cagle SD, Cooperstein N. Coronary Artery Disease: Diagnosis and Management. Prim Care. 2018;45(1):45-61.
Crawford JH, Townsley MM. Steroids for Adult and Pediatric Cardiac Surgery: A Clinical Update. J Cardiothorac Vasc Anesth. 2019;33(7):2039-2045. doi:10.1053/j.jvca.2018.11.023
Dieleman JM, Nierich AP, Rosseel PM, et al. Intraoperative High-Dose Dexamethasone for Cardiac Surgery: A Randomized Controlled Trial. JAMA. 2012;308(17):1761-1767. doi:10.1001/jama.2012.14144
Malaisrie SC, Szeto WY, Halas M, et al. 2021 The American Association for Thoracic Surgery expert consensus document: Surgical treatment of acute type A aortic dissection. J Thorac Cardiovasc Surg. 2021;162(3):735-758.e2. doi:10.1016/j.jtcvs.2021.04.053
Whitlock RP, Devereaux PJ, Teoh KH, et al. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): a randomised, double-blind, placebo-controlled trial. Lancet. 2015;386(10000):1243-1253. doi:https://doi.org/10.1016/S0140-6736(15)00273-1
Dvirnik N, Belley-Cote EP, Hanif H, et al. Steroids in cardiac surgery: a systematic review and meta-analysis. Br J Anaesth. 2018;120(4):657-667. doi:https://doi.org/10.1016/j.bja.2017.10.025
McClure GR, Belley-Cote EP, Harlock J, et al. Steroids in cardiac surgery trial: a substudy of surgical site infections. Can J Anaesth. 2019;66(2):182-192. doi:10.1007/s12630-018-1253-5
Alghamdi BA, Alharthi RA, AlShaikh BA, et al. Risk Factors for Post-cardiac Surgery Infections. Cureus. 2022;14(11):e31198. doi:10.7759/cureus.31198
Royse CF, Saager L, Whitlock R, et al. Impact of Methylprednisolone on Postoperative Quality of Recovery and Delirium in the Steroids in Cardiac Surgery Trial: A Randomized, Double-blind, Placebo-controlled Substudy. Anesthesiology. 2017;126(2):223-233. doi:10.1097/ALN.0000000000001433
Cotogni P, Barbero C, Passera R, Fossati L, Olivero G, Rinaldi M. Violation of prophylactic vancomycin administration timing is a potential risk factor for rate of surgical site infections in cardiac surgery patients: a prospective cohort study. BMC Cardiovasc Disord. 2017;17(1):73. doi:10.1186/s12872-017-0506-5
Gao G, Wu Y, Grunkemeier GL, Furnary AP, Starr A. Long-term survival of patients after coronary artery bypass graft surgery: comparison of the pre-stent and post-stent eras. Ann Thorac Surg. 2006;82(3):806-810.
Alexander JH, Smith PK. Coronary-Artery Bypass Grafting. N Engl J Med. 2016;375(10):e22.
doi:10.1056/NEJMc1608042
Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice
Guidelines. Circulation. 2011;124(23):e652-735. doi:10.1161/CIR.0b013e31823c074e
Matros E, Aranki SF, Bayer LR, McGurk S, Neuwalder J, Orgill DP. Reduction in incidence of deep sternal wound infections: random or real? J Thorac Cardiovasc Surg. 2010;139(3):680-685.
Hamouda K, Oezkur M, Sinha B, et al. Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study. J Cardiothorac Surg. 2015;10:25. doi:10.1186/s13019015-0225-x
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
