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British Journal of Anaesthesia, 2003, Vol. 90, No. 6 728-732
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia


Clinical Investigations

Effects of dexamethasone on clinical course, C-reactive protein, S100B protein and von Willebrand factor antigen after paediatric cardiac surgery

L. Lindberg1, C. Forsell1, P. Jögi2 and A.-K. Olsson

1 Department of Pediatric Anesthesia and Intensive Care, University Hospital, Lund, Sweden. 2 Pediatric Cardiac Surgery, University Hospital, Lund, Sweden

Corresponding author: Department of Pediatric Anesthesia and Intensive Care, University Hospital Lund, S-221 85 Lund, Sweden. Email: larsolavlindberg@hotmail.com

Background. Anti-inflammatory treatment with glucocorticoids during cardiopulmonary bypass can reduce inflammatory mediator release, but the effects of glucocorticoid on outcome are controversial.

Methods. We studied the effects of dexamethasone on clinical course, C-reactive protein, von Willebrand factor antigen (vWf:Ag) and S100B in a randomized masked study of children after open cardiac surgery. Twenty children weighing >10 kg received dexamethasone (1 mg kg–1) and 20 controls received saline after induction of anaesthesia. We measured vWf:Ag as a marker of endothelial activation, S100B as a marker of cerebral protein release and C-reactive protein as a marker of inflammatory activity. Oxygenation, body temperature, fluid balance, leucocyte and platelet counts, days in the intensive care unit (ICU) and days on mechanical ventilation were noted.

Results. Dexamethasone decreased C-reactive protein concentration on the first postoperative day (P<0.05), but did not affect the release of vWf:Ag or S100B. There was no significant difference in oxygenation, body temperature, fluid balance, leucocyte and platelet counts, days in the ICU or days on mechanical ventilation between the placebo and dexamethasone-treated groups.

Conclusion. Administration of dexamethasone before cardiopulmonary bypass for paediatric cardiac surgery decreased the inflammatory response, but did not affect the immediate features after surgery or changes in vWf:Ag or S100B.

Br J Anaesth 2003; 90: 728–32


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