Cardiac surgery is sometimes associated with organ dysfunction of variable severity (renal
insufficiency, cognitive decline, arrhythmias, ARDS). The phenomenon responsible is an
intense inflammatory reaction induced by cardiopulmonary bypass, leading to microcirculation
alterations, specially in endothelial cell and its protective layer - glycocalyx. Endothelial
dysfunction then reduces the reactivity of peripheral tissues to hypoxia, and is associated
with bad prognosis.
High - dose corticoids administration at anesthesia induction in cardiac surgery could
attenuate the intensity of this inflammatory reaction, and represents the current practice in
our hospital. Nevertheless, this attitude is abandoned in numerous cardiac surgery centres.