Key result
Corticosteroids, NSAIDs, and colchicine lack sufficient high-quality evidence for treating pediatric postoperative pericardial effusion.
Why the study?
The efficacy of corticosteroids, NSAIDs, and colchicine in treating postoperative pericardial effusion following cardiac surgery in the pediatric setting needed to be investigated and compared.
Do corticosteroids, NSAIDs, or colchicine improve postoperative pericardial effusion in pediatric patients following cardiac surgery?
Systematic Review
Do corticosteroids, NSAIDs, or colchicine improve postoperative pericardial effusion in pediatric patients following cardiac surgery?
There is a critical lack of high-quality evidence regarding the pharmacological treatment of postoperative pericardial effusion in children, highlighting an urgent need for pediatric-specific randomized controlled trials.
No evidence-based treatment for pediatric PPE can be recommended; leaves open the need for dedicated pediatric RCTs.
The objective of this study is to investigate and compare the efficacy of corticosteroids, NSAIDs, and colchicine in treating postoperative pericardial effusion (PPE) following cardiac surgery in the pediatric setting, on the basis of available literature. To investigate and compare the efficacy of corticosteroids, NSAIDs, and colchicine in treating postoperative pericardial effusion (PPE) following cardiac surgery in the pediatric setting, on the basis of available literature. A systematic review was conducted by carrying out a database search in PubMed on April 20th, 2021. An English language filter was added, but no time restrictions were applied. Lack of pediatric literature prompted a broadening of the search to include adult literature. One pediatric and four adult studies were included, but the pediatric evidence was not found to be of satisfactory quality, and the findings of adult literature could not be readily generalized to the pediatric setting. No well-founded conclusions could be drawn regarding the efficacy of corticosteroids, NSAIDs, or colchicine in treating PPE, as a striking lack of evidence for their efficacy in the pediatric setting were revealed. A knowledge gap was found in the literature, indicating a need for good-quality randomized controlled trials to bridge this gap.
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Somani et al. (2022) conducted a systematic review in Postoperative pericardial effusion (PPE). Corticosteroids, NSAIDs, and colchicine vs. Placebo was evaluated on Resolution or decrease in severity of postoperative pericardial effusion. A systematic review found insufficient high-quality evidence to draw well-founded conclusions regarding the efficacy of corticosteroids, NSAIDs, or colchicine in treating pediatric postoperative pericardial effusion.
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