Evaluation of Corticosteroid in Systemic Inflammatory Response Syndrome
Status:
Completed
Trial end date:
2020-11-01
Target enrollment:
Participant gender:
Summary
Cardiac surgery and cardiopulmonary bypass (CPB) initiate a whole-body systemic inflammatory
response (SIRS) characterized by the activation of leukocytes, monocytes, and the complement
cascade. Multiple mediators of the inflammatory process are released, including cytokines,
endothelin, adhesion molecules, and oxygen free radicals. An exaggerated release of these
mediators may contribute to numerous postoperative end-organ complications, including
myocardial dysfunction, neurologic impairment, respiratory failure, altered renal and hepatic
function, bleeding disorders, and multiple organ failure. Although most cardiac surgical
patients do not experience major adverse events, it is likely that the inflammatory response
impairs clinical recovery to some degree in all patients.
A large number of therapeutic strategies have been developed to attenuate the inflammatory
reaction to CPB and thereby enhance recovery of the cardiac surgical patient. Intraoperative
corticosteroid administration has been studied extensively as a primary pharmacologic
anti-inflammatory treatment option.