Cardiac surgery with cardiopulmonary bypass results in an inflammatory response of the body that is usually associated with adverse outcome. The preventive use of corticosteroids attenuates this response although the benefit is not documented.7507 patients with a planned cardiac surgery were randomizedto methylprednisolone or placebo with the primary objective of assessing the mortality at 30 days. No difference in 30-day mortality between the two groups (corticosteroid 4.1 versus placebo 4.7 %, p = 0.23) was observed.There was a higher incidence of stroke in the methylprednisolone group (13.3 % versus 10.9 %, P = 0.001).
Conclusion
Methylprednisolone does not reduce mortality in patients undergoing cardiac surgery with cardiopulmonary bypass, and there is an increment of the stroke risk in the postoperative period.
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Richard Whitlock
2014-03-31
Original title: Steroids in Cardiac Surgery Trial (SIRS).