Key result
The available evidence for prophylactic steroid use in pediatric cardiac surgery is conflicting and limited by small sample sizes and retrospective designs, providing no clear consensus on clinical benefits.
Why the study?
Does perioperative steroid administration improve clinical outcomes in children undergoing heart surgery?
Does perioperative steroid administration improve clinical outcomes in children undergoing heart surgery?
There is currently insufficient high-quality evidence to definitively support or refute the routine use of prophylactic steroids in paediatric heart surgery, highlighting the need for large randomized controlled trials.
Insufficient evidence precludes routine steroid use in paediatric heart surgery; leaves open the need for definitive RCTs.
Steroids in paediatric heart surgery are given prophylactically to blunt the systemic inflammatory response induced by the extracorporeal circuit and to improve clinical outcomes. However, there is an ongoing controversy about the impact of steroids on clinical outcomes after paediatric heart surgery. The hypothalamic-pituitary-adrenal axis is the primary neuroendocrine system activated during the stress of surgery. Relative adrenal insufficiency can accompany paediatric heart surgery; therefore, perioperative steroid supplementation is still administered by some centres. The studies that investigate the hypothalamic-pituitary-adrenal axis physiology during surgery have many limitations, and it is unclear how to define what is adrenal insufficiency. In this review, we focus on discussing the available evidence for steroid use in paediatric cardiac surgery.
No takes yet. Share an insight, caveat, or question.
Fudulu et al. (2018) conducted a review in Paediatric heart surgery. Steroids was evaluated. The available evidence for prophylactic steroid use in pediatric cardiac surgery is conflicting and limited by small sample sizes and retrospective designs, providing no clear consensus on clinical benefits.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: